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HomeMy WebLinkAbout02-08-12COMMONWEALTH OF PENNSYLVANIA REV-1162 EX111-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015565 RYDER HARVEY L 485 CHESTNUT GROVE ROAD DILLSBURG, PA 17019 --- ,o~~ ESTATE INFORMATION: SSN: 161-32-3748 FILE NUMBER: 211 1-1302 DECEDENT NAME: RYDER MARIAN ANNE DATE OF PAYMENT: 02 f 08 f 201 2 POSTMARK DATE: 02/06/201 2 couNTY: CUMBERLAND DATE OF DEATH: 10/15/2011 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12500310 ~ 5515.46 12500313 ~ S 1,034.14 TOTAL AMOUNT PAID: REMARKS: 51,549.60 CHECK# 6493 INITIALS: DMB SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r r~ nl~f•r\ „_ INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AFC-nr;'._fr!_: ;,~" AND PO BOX 280601 HARRISBURG PA 17128-0601 P~~;!`; ( ;~''~- ' TAXPAYER RESPONSE ...,. REY -1543A AFP (7-80) FILE N0. 21 11-1302 ACN 12500310 DATE 02-02-2012 _M 1 f 1 ~j~ 1 CLERft CF QRf:'NAN'S COaf~ T CUftfR-ref 4;~~r,C„ pq HARVEY L RYDER 485 CHESTNUT GROVE RD DILLSBURG PA 17019-9576 TYPE OF ACCOUNT EST. OF MARIAN A RYDER ^ SECURITY S.S. N0. 161-32-3748 X^ SEC Accr DATE OF DEATH 10 -15 - 2011 ^ STOCK COUNTY CUMBERLAND ^ soNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 AMERIPRISE FINANCIAL 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 answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 010108201913002 To insure proper credit to your account, two C2) copies of this notice must accompany your payment to the Register of Wills. Make check DOD Valuation 12, 886 • 61 payable to: "Register of Wills, Agent". Percent Taxable X 33.333 NOTE: If tax payments are made within three Amount Subject t0 Tax 4,295.49 (3) months of the decedent's date of death, Tax Rate X 1 2 You may deduct a 5Y. discount of the tax due. Anv inheritance tax due will become delinquent Potential Tax Due 515.46 nine (9) months after the date of death. PART TAXPAYER RESPONSE 0 F~4IL:~tE-T9 3$ I+(IL.LRES31{.T. Iti'A,h1.:8FFiC~A#.. FAX AS .~~M~biT+ BAS3 ~i TH~S .N~3TICE A. ^ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or you may check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the decedent's representative. C. ^ The above information is incorrect andJor debts and deductions were paid by you. You must complete PART ~ and/or PART ^3 below. PART If you indicate a different tax rate, please state your O relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) LINE 1. DOD Valuation 2. Percent Taxable 3. Amount Subject to Tax 4. Debts and Deductions 5. Amount Taxable 6. Tax Rate 7. Tax Due 1 2 x 3 4 - 5 6 X 7 gOFFI~IAt USE OUiY ^ AAF PA DEPARTMENT OF REYENU~ i 2 3 4 5 6 7 8 PART ^3 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID PAD Under. penalties of perjury, I declare that the facts I have reported above/are true,,/correct and complete to the best of my knowledge and belief. HOME C~/~ ) ~'3oZ-'SS~ff' /~ M WO R K C ) Off, Off- / Z-- TAXPAYER IGNA E TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMI~Ia~~~~1UEn~'~C r~' INFORMATION NOTICE BUREAU dP~-tNbIVIDUAL TAXES -. V. AND PD BOX 28 Q1[pi ~ HARRISBUR~k!cpA'~7x2s o~ol ~'{'. # 1 TAXPAYER RESPONSE REY -1543A AFP (7-40] CLERK'; oR~-an,~s co~~Rr CUMB~'?(,a~~ ~ ; Ci'? , PA FILE NO. 21 11-1302 ACN 12500313 DATE 02-02-2012 HARVEY L RYDER 485 CHESTNUT GROVE RD DILLSBURG PA 17019-9576 TYPE OF ACCOUNT EST. OF MARIAN A RYDER ^ SECURITY S.S. N0. 161-32-3748 0 sEC ACCT DATE OF DEATH 10-15-2011 ^ srocK COUNTY CUMBERLAND ^ soNOs REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 AMERIPRISE FINANCIAL 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. puestions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 010108201905002 T~ d t t t DOD Valuation 25,853.83 o insure proper cre i o your accoun ..... C2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Percent Taxable X 33.333 NOTE: If tax payments are made within three Amount Subject to Tax 8,617.86 C3) months of the decedent's date of death, TaX Rate X , 12 you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 1 , 034.14 nine l9) months after the date of death. P~T TAXPAYER RESPONSE 1 F~,1~tU'RE T.O RESPi}ND ~W7L& ~2E ~T IN AN, UfFIGIA~.: ~AX.4S5~SSMENT BASED ON T#IiS NOTICE A. ^ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or you may check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART If you indicate a different tax rate, please state your ~ OFFICIAL USE ONLY ^ AAF © relationship to decedent: PA DEPARTMENT OF REVENllE TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) PAI3 w LINE 1. DOD Valuation 2. Percent Taxable 3. Amount Subject to Tax 4. Debts and Deductions 5. Amount Taxable 6. Tax Rate 7. Tax Due 1 ~ 1 2 X I 2 3 3 4 - 4 5 rj 6 x 6 7 7 8 PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best o my knowledge and belief. HOME C 7/7 ) ~ ~~-7..S~f~ WORK C ) ~Sd,- aS ~Z TAXPAYE SIGNAT E TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ ~ -Sl ..,E tip! ~, , - .. fi `+-_ '1 11~ _,. {~ ` ~ ""~"' `~ ~R'~ ~y II ~~ C /'~ e itk •~ J ~ ^~o w ~` ti _ ~ '~ ~ ~~/ : STS r~ ,~. ~~~ ~,~~ ~~ ~ .> ~~