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Home My WebLink About02-07-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 015556 WILSON MICHELLE 4 BIG SPRING TERRACE NEWVILLE, PA 17241 fold ESTATE INFORMATION: SSN: »~-54-6874 FILE NUMBER: 2112-0164 DECEDENT NAME: DURF DONALD L DATE OF PAYMENT: 02/07/2012 POSTMARK DATE: 02/06/201 2 couNTY: CUMBERLAND DATE OF DEATH: 08/30/201 1 REMARKS: SEAL CHECK# 1 141 ACN ASSESSMENT AMOUNT CONTROL NUMBER 01 185158 ~ S 1 15.64 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: 5115.64 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 ~ ~ { ~~ BUREAU OF INDIVIDUAL TAXES - Po Box zao6ol Penn t_;+~~~(,~ j~/' AND ACN 11185158 HARRISBURG PA 17128-0601 DEPARTMEN -P~I~~Ut r,;.. ~ i(i "TAXPAYER RESPONSE REV-1543 E% AFP'(OS'lt)~ ~ '~' ~ ~~~ ~1.•V DATE 12 - 3 0 - 2 011 ~G11 ~~G _~ i ~ ~~~ ~ ~ EST. OF DONALD L. DURF SSN 171-54-6874 ~R~ ~~ DATE OF DEATH 08-30-2011 ('ORPHAN'S COURT COUNTY CUMBERLAND "`~`~~~~ ~~i~,' t,,`J, ~ REMIT PAYMENT AND FDRMS T0: MICHELLE L WILSON REGISTER OF WILLS 4 BIG SPRING TER 1 COURTHOUSE SQLIARE NEWVILLE PA 17241-9468 CARLISLE PA 17'013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. ACNB BANK provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. If you are the Spouse of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must 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. 9653198 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 11-23-1987 Established $ 5,139.48 X 50.000 $ 2,569.74 X .045 $ 115.64 To ensure proper credit to the account, twa copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If it ax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due wlll become delinquent nine month:: after the date of death. PART TAXPAYER RESPONSE ~ AI`,~~11RE 7' E HD Wilt 1t~S ; `: IN A I L T SES A. V I The above information and tax due is correct. ~I Renit 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 return this notice to the Register of Wills and C 0 N E ~ 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 filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. 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 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID ONE NLIMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I reported above--/ar^e~ true ,,~.c/orrectgan~d`, f~' mplete to the best of •my~'kn,,o^wledge and belief. HOME C 1 ~ I J~ /~~'~SU~ / / / ~~~~~ /~-t.~-~'" WORK C J~ -~' ~ . G -s. G~ G ~n te V ' -- r , 'p r "~ ,, rte- '=> ~"_ . I `~ ~ J ~` L ~` -Q C~' ~• L~ t-• 4 !:~ ~} i~~ J J~ n ~~~bbb ~ /l-~ ~~ ~ V X ~O ,~ ~ ~ ~~ ?,'_~ ~~ ~ ~~x ~ ~ ~~ ~fi -y // V ' ..~ .,~ ~~ ti G17 '~1 ~ :~ , ~1r'~ V~ __ (' •! ~_ ' 9N t E . .~ f : a> i ct "r F~ , AZALE ~; 7 GO O Z a' ~ FOPEVEN