HomeMy WebLinkAbout02-08-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT Of REVENUE
BUREAU Of INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG,. PA 17128-0601
RECEIVED FROM:
SMITH ADAM
107 E SPRINGVILLE ROAD
BOILING SPRINGS, PA 17007
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION:
FILE NUMBER: 2112-0063
DECEDENT NAME: SMITH GARY L
DATE OF PAYMENT: 02/08/2012
POSTMARK DATE: 02/08/2012
COUNTY: CUMBERLAND
DATE OF DEATH: 01 /01 /2012
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
12107216 ~ 51,384.84
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 2487
SEAL
51, 384.84
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 015563
REGISTER OF WILLS
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aUREAU OF INDIVIDUAL TAXES "
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HARRISHUR6 PA 17128*-0601 DEPNt71FE1
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PENNSYLV~-NIA INHERITANCE T
INFORNATLON NOTICE
AND
~AAYER RESPONSE
FILE N0. 21
ACN 121072i(
DATE 01-3~w`2Q12
-_ ,.„~ . ~~ rr.,:~.r~. .~., TYPE OF..AGCOUNT
Z~t2FEB -8 PM !~ ~~ EST. OF GARY L SMITH ,~~],swlNCs
SSN ,194-40-456.2 •~ CIiECKIN6
DATA OF 'DEATH '' 01-01-2012~'TRU$T
C%L.~RK ~ C CUN$E1~LAND , ^ CERTIF.
- f~iFt~P!'ppR~~1~1ppS~~~~ryCQ~~,I/J'~R~' .. ~'
~~11t/~V~ trLJ, ~ REMIT PAYMENT AND FORMS T0:-
~~ REGiST-ER OF WIl.1.S .
ADAM` C-SMITH ~
10'7 E SPRINGVILLE RD 1 CWIRTHOUSE S~UAR~E `
BOILING- SPRINGS PA 1707-9737' g CARLISLE PA 17013-
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NEW CUMIffRLAND FCU= provided the department with the-information below, which was used~in calculating tht inharltmi~e tax due.
Recards,indlr,;~th.that~at the death of-the above-named decedent, ~+u were a ioint owner/beneficiary of this account, =~f yOU,sre the,,~pmatte„r4f the
deceppsed and any aPount other than zero is reflected 4e1oM on the Potential Tax. Due 11ne, note-rio tax may be due, bltt dust
notify the d®~artia~nt of your relationshlp`to the deceased by checking Box C 1n PART 1 below avid ivrttlny "spouse" h P,dRT 2''
If ,You believe. he infbrmation is incorrect, please obtain written correction from the financial institution; attach.a copy to this totem and return
it to the above address. Please call 717-787-8327 with questions.
~~:_--..,:,.;.aCD~lp,1;~-=6t.Aii:~- '. °{•~^~--=.`' S'~E~.~.1t~R~C~.IIE.-:FIrR-t~II-IN~_Al~ PBY1~ _- :-._..~__,. ~ ~..~
Account No. 76979 Dat• '- 10 ~ OS-1999 To ansuro proper credit to th• accnun;~ two" ,:
Established copies of thus notipe, must accoaau»r •-
Account Balance ~ 61,548.53 pav~ant to the Register of Wills,, •-~~ check
payable to "Register of Wills. AOent".
Percent Taxablo X 50:`00'0
^+--~-•-~-++ NOTE: - If tax payaonts era aade~ wltMn throe
Amount Subiect to Tsx $ 30 , 774.27. aonths of the decedent's date of death,
Tax Rat• X , p45;- a.au~t a 5 pircont discount on i:he tai dui:''
Any inhoritanie ttax"dW will baCOa~ UOl1A4ugnt
Potential Tax Due ~` 1`i 38k'.84~ nine ionths aftor the data of death.'
P~r .TAP ~E :: E` ,''.:,
1
iJ this ~rotiee ,ta obtain'
A. l.~l TM Rea~it ipayrentttb Thad tax 'dor of"Wiliscga$.th-two cbe3es of .
-CHECK a discount or avoid intt, .or return'this notice to the Roe#skir of Wills and '
ONE an official assassaent'*wil'•1`be issiaid by ;the PA Departaent of Reronue.
'BLOCK ~ B. ~ The above asset has been or will be reported and tax pef'tl with the'Pennsylvania inheritance tax roturn
[INLY f31ad.,by, the estate reprasantative. -
C. ~ Ths above info ion is ineerr t and/or debts and deductions wore paid.
Coaplato PART r 2 'and/or PART ~ below.
t.
PART It irtdicatlnp a different to rate,;, please state
'' ' 'rala~tionsl~~is to decsd+epia": ,
TAX RETURN -'C~~.CUL~7ION OF TAX-ON JOINT/TRUST"ACCOUNTS:
LINE 1: Date Emtab3isirtd 1 .. ' . ` "`.
2..-Account. Balance 2
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6 $
7. .Tax Rate 7 ,X
8. TaX~Duo - $ ~
PART D BTS b~DUCTIONS'CLATMEU _ .
0 _
DATE PALD PAYEE. DESCRIPTION AMOUNT PAID
,, TDTAL CEi~ter on Litta; 5, of Tex Go~putatiQnl, #_
Undsr penafities''of per~lrry, 2 'do'aYare that the facts I rrporte`d above are true",. correct load
complete ~o the bdst of u-Y knbwladge and belief. HOME C )' ,
TAXPAYER IGNATURE TELE H0 NUMBER .DATE.