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Home My WebLink About01-12-12 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: COOK MARY M 11 13 NORTH HIGH STREET DUNCANNON, PA 17020 -- fold REMARKS: SEAL CHECK#1654 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER TOTAL AMOUNT PAID: INITIALS: CJ RECEIVED BY: REGISTER OF WILLS AMOUNT S 1 14.04 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 015443 .~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE NO. 21-'It ~~~~~~`~ BUREAU OF INDIVIDUAL TAXES ._ ~',° ter AND ACN 11177303 Po Box zso6ol pE1111Sy~V~1°I~ -, __ DATE 11-24-2011 HARRISBURG PA 17128-0601 DEPARTMENT OFREVENUE ... - TA~~ AY E R R E S P O N S E REV-1543 EX RFP (05-r 41)'~~~ ` TYPE OF ACCOUNT • es + '~ r ~ SAVINGS ~4 t~ ~ rc`. ~~EST. OF SHIRLEY STONER i SSN 188-32-4704 ~ CHECKING TRUST ~L~;-.., ~ _ DATE OF DEATH 11-12 - 2011 COUNTY CUMBERLAND ~ CERTIF. ~J~I~f A ~ ~ ` ~ ~ ~-+, - ~ ~`~ REMIT PAYMENT AND FORMS T0: MARY M COOK REGISTER OF WILLS 1113 N HIGH ST 1 COURTHOUSE SRUARE DUNCANNON PA 17020-1921 CARLISLE PA 17013 RIVERVIEW NATIONAL BANK provided the department with the information below, which was used in calculating the inheritance tax due. deceaseddandtanyaamounteother thanezeroeisareflectedtbelowwonetheoPotentialbeTax~Dueylineh~noteono tax mayobe duehbut youemusthe notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3067664 Date 06-03-2008 7o ensure proper credit to the account, two copies of this notice must accompany Established payment to the Register of Wills. Make check Account Balance $ 15,204.40 payable to "Register of Wills, Agent". X 1 6. 6 6 7 NOTE: If tax Payments are made within three Percent Taxable AmOUnt Subject to Tax $ 2,534.12 months of the decedent's date of death. . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X Any inheritance tax due will become delinquent Potential Tax Due $ 114 • U4 nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT CHECK ONE C BLOCK ONLY A. ~j The above information and tax due is correct. ~J Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate representative. C The above informs ion is incorre~t belowr debts and deductions were paid. Complete PART 2~ and/or PART PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 '~ 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate R TaY Due PART DATE PAID PAYEE 3 X 4 $ 5 6 '~ 7 X 8 $ PAD OFFICIAL USE DNLI' 1 I ~Ar PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above are true,~c~rre3G 3 z complete to the best of my knowledge and belief. HOME C ~~~ ~~ - WORK C ~ 1 '// -/L TELEPHONE NUMBER DATE rwv VCQ CTrNATURE