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HomeMy WebLinkAbout02-08-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA. INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SICO DANIEL 844 ALLENVIEW DR MECHANICSBURG, PA 17055 REV-1162 EX(11-96) NO. CD 015564 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ss-v: cos-2o-8934 FILE NUMBER: 21 1 1 -1081 DECEDENT NAME: SILO LUCILLE C DATE OF PAYMENT: 02/08/201 2 POSTMARK DATE: 02/07/2012 COUNTY: CUMBERLAND DATE OF DEATH: 09/08/201 1 12500017 ~ $79.76 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK#1012 INITIALS: HMW RECEIVED BY: 579.76 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 INFORMATION NOTICE -FILE NO. 21 11-1081 AND ACN 12500017 TAXPAYER RESPONSE DATE 01-11-2.012 x02 FE6 -g PM f2~ 58 PART ~I TYPE OF ACCOUNT EST. OF LUCILLE C SICO ^ SECURITY S.S. N0. 109-20-8934 Q $EC ACCT BATE OF DEATH 0 9 - 0 8 - 2b 11 [] XTOCK COUNTY CUMBERLAND ^ BONDS REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 METLIFE has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. _ _ Questions.,may be answerad..by.~ahing„('T172 787-6327.. .,, ,~ _.. . COMPLETE PA~tT 1 BELOW '~ * * ~E~~REV~RSE SIDE FOR FILING 'AND PAYMENT INSTRUCTIQNS Account No. 806195528819 f~~R~C ~' T ((~t11MBFt~~A,N~? ~1~1R.pA DANIEL SILO 844 ALLENVIEW DR MECHANICSBURG PA 17055-6183 DOD Valuation Percent Taxable Amount Subject to Tax Tax Rate Potential Tax pue; CHECK C ONE BLOCK ONLY To insure proper credit to your account, two C2) copies of this notice must accompany your 1 7 7 2.3 6 payment to the Register of Wills. Make check , payable to: "Register of Wills, Agent". x 100.00 1,772.36 X .045 79.76 The above information and tax due is correct. 1. You may choose to remit•,om~^ent to tha.~~egister of Wills with two copies pf this ootice to obtain a discount or avoid interest. ort you may check, box "A" and return this eotice:to the Register of Wills and an official assessap9nt';will be issued by the. PA Department of Revenue. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART O3 below.. PART If you indicate a different tax rate, please state your © relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) LINE 1. DOD Valuation 1 2. Percent Taxable 2 X ,, s *r •<_-- "- __-" '3. ~~fA3'UTf~`SQ63~Et_TO_TaX _ ,,y.-_--,-_---:-- _,._______._ _~ - -> -- -- _ - - 4. Debts and Deductions 4 - ~ ,xr, ~~,'~ .. 5. Amount Taxable 5 ~',~ ''"` ~.._ 6. Tax Rate 6 X ~ #`~~ "~`` 7. Tax Due 7 s x.:: 'q_„, PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reports4l above are true,. correct and i to to the best my knowledge and belief. HOME. C ~~7 ) ~ ~' ~ WORK C ) AYER S'IGNAT RE TELEPHONE NUMBER DA NOTE: If tax payments are made within three C3) months of the decedent's date of death, you may deduct a 5X discount of the tax due. Arty inheritance tax due will become delinquent nine C9) Months after the date of death. 6. ~ The above asset has beets or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~~; 4 ~~ W +W ~r w .'~°w. .."`... ."... w. Y YYr Wi tllll~~ ~~ W~ milt 1~~ ~~4Y RED ~ ~~ ~t;~ 3~~,~~ 8 PM ~2: 58 p~Rlt C?fi G{~1B~R~q,~~~~RP~A ~ ~.-- fi'i ~ 7a ~ ~ r r ~ m ~ ~ ~~ G Q !!! ~ c r ~ ~ O ^ (' l ~~ ~. a~,s g IT r p e ~'~' ,.,/ Z