HomeMy WebLinkAbout01-13-12 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT Of= REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-961
NO. CD 015456
EMANUEL ELLEN L
1 1 14 STONE HARBOR BLVD
STONE HARBOR, NJ 08247
fold
ESTATE INFORMATION: SSN: 797-14-5244
FILE NUMBER: 2112-0054
DECEDENT NAME: STRAUSSER ANNE C
DATE OF PAYMENT: 01 / 1 3/201 2
POSTMARK DATE: 01 /1 1 /201 2
CouNTY: CUMBERLAND
DATE OF DEATH: 04/ 1 0/201 1
REMARKS:
CHECK# 221
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11174123 ~ 543.79
TOTAL AMOUNT PAID: 543.79
INITIALS: HEA
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~ PENNSYLVANIA INHERITANI:E TAX
INFORMATION NOTICE: FILE No. 21
BUREAU OF INDIVIDUAL TAXES
Po Box zao6ol Pennsylvania AND ACN 11174123
HARRISBURG PA 17128-0601 DEPARTMENT OF REVENUE TAX P AY E R R E S P O N S E
DATE 11-11-2011
REV-1543 E% AFP (a5-11)
TYPE OF ACCOUNT
EST. OF ANNE C: STRAUSSER ^ SAVINGS
SSN 197-14-5244 Q CHECKING
DATE OF DEATH 04-10-2011 ^ TRUST
COUNTY CIIMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0: ('~ _
ELLEN L EMANUEL REGISTER OF W]:LLS ~~ " -r .T-1
APT 102 1 COURTHOUSE SQUARE r?..~ s _
1114 STONE HARBOR BLV CARLISLE PA 17013 ~i~•~ .~ ~-
STONE HARBOR NJ 08247-144 0 ~ ?'T"! - `-`
~ ~'r' G.7
_,,
C =, ~ ..~
- __.
_ ~ r.~:
METRO BANK provided the department with the information below, which alas used in cal-aYing the ~'~ritance t;eyrjdue.
Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. f y0U are the SpOJ~SP, f the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due; but y t
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse~t`in PART 2.
If you believe the information jes incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
it to the above address. Pleas call 717-787-8327 with Questions.
COMPLETE PART 1!BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 537 1 48 0 4 1 Date 09-28-20.05 To ensure proper credit to the account, two
Established copies of this notice oust accompany
Account Balance 583.86 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 291.93 months of the decedent's date of death,
Tax Rate ~( , lrj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due ~` 43.79 nine months after the date of death.
PART TAXPAYER RESPONSE
^ eT~'F PnNn ~ •Ni FT\~ ~L~~T ENT.
CHECK
C ONE
BLOCK
ONLY
The above information and tax due is correct.
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.
B. ^ The above asset has been or will be reported and tax paid with i:he Pennsylvania inheritance tax return
filed by the estate representative.
C. ^ The above informs ion is incorrect and/or debts and deductions are re paid.
Complete PART ~ and/or PART 3^ below.
PART If indicating a different tax rate, please state ~ ~ OFFICIAL tJSE ONLY ^ AAF
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 ~ 1 °~
2. Account Balance 2 $ ~
3. Percent Taxable 3 X .~ -_-~_-.~
4. Amount Subject to Tax 4 $ 4 ~ '~
5. Debts and Deductions 5 5
6. Amount Taxable 6 $ 5
7.
Tax Rate 7
X
7 a
8. Tax Due 8 $ $
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
/~ / TOTAL CEnter on Line 5 of Tax Computation) 8
Und p lties o~ erjury, I decla a that the facts I reported above r/e true,?~r ect and11
co p to the b s m Howled and belief. HOME ( (/~~) ~~- ~ ~~J
~~ WORK C )
A E SIGNATU E TELEPHONE NUMBER DATE