Loading...
HomeMy WebLinkAbout02-07-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 015553 COLEMAN STEVONNA A COLEMAN 19 FARM HOUSE LANE CAMP HILL, PA 17011 ~o~a ESTATE INFORMATION: ssN: 4as-ze-eoas FILE NUMBER: 2112-0161 DECEDENT NAME: JACOBS S THOMAS DATE OF PAYMENT: 02/07/2012 POSTMARK DATE: 02/06/2012 couNTY: CUMBERLAND DATE OF DEATH: 12/02/201 1 ACN ASSESSMENT AMOUNT CONTROL NUMBER 121037"15 ~ 587.42 REV-1182 EXI11-96) TOTAL AMOUNT PAID: REMARKS: STEVONNA A COLEMAN CHECK# 8471 INITIALS: WZ SEAL RECEIVED BY: 587.42 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE (~ BUREAU OF INDIVIDUAL TAXES FILE N0. 21~ ~~ ~1 `rl PO BOX 280601 ~ ~.-~~~~ FUIRRISBURG PA 17128-0601 Penn ( r, ACN 12103715 DEPARTMEN XPAYER RESPONSE ~ n ' •,r,~~!-~ DATE 01-16-2012 REV-1543 EX ));. !ti L) STEVONNA A COLEMAN 19 FARM HOUSE LN ZOIZ FEB -7 AM (! ~ 46, CLERK OF ORPHAN'S COURT CUN~F.RL.A~!4~ C,O.. PA. CAMP HILL PA 17011-8303 EST. OF S T JACOBS SSN 485-28-8085 DATE OF DEATH 12-02-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PNC BANK NA provi detl the department with the information below. which was used in calculating the inherttance tax due. Records indicate that at the death of the above named decedent, you were a 3oint owner/beneficfary of this account. If y0U ere 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 coDY to Lhis form and return itto the, above address. P1 ease ca11717-787-8327 with ques tT ons. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5140031733 Dato 10-01-1973 To ensure proper credit to the account. two Established copies of this notice east accoapanv Account Balance ~ 3.753.00 Pavaent to the Banister of Wills. Nako check paY able to "Registor of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax TeX Rate ~` X 1 ~ 876 • 50 1 rj NOTE: If tax pavaents ere wade within three aonths of the decetlent's date of death, deduct a 5 percent discount on the tax due. POtentSal Tax Due 281 • 48 A)nr inheritance tax due will becoae delinquent nine aonths after the date of death. PART A. ~ Tho above inforaation and tax due is correct. Roait payaent to the Resistor of Wills with two copies of this notice to obtain CHECK a discount or avoitl interest, or return this notSca to the Register of Wills and ONE an official assessaant will bo issued by the PA Departaent of Revenue. BLOCK B. ~ Tha above asset has boon or will be reported and tax paid with the Pennsylvania inheritance tax return ONLY ma~yy(( filed by the astste'"'represantative. C. ~7y Tha above info a ion is incorr ct and/or debts and detluctions ware paid. 7T""'"' Coaplete PART ~ and/or PART 3~ bal ow. PART Lf indicating a different tax rata, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1: Data. Established 1 !U - ~ - <9 7 3 2. Account Balance 2 ~ 3 r'v` b O 3. Percent Taxable ~ 3 _X... ~. ~ ~ _ fad ~ ~ ~ • .. 4. Amount Subject to Tax 4 $ /issZ ~ ~~ 5. Debts and Deductions 5 - ~{„if '. i~,/f a. Amount Taxable 6 ~ .~~, 7. Tax Rata 7 X s B.Tax Duo 8 ~ p , 4 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Llne 5 of Tax Computation) ; Under penalties of perjury, I declare that the facts I reportetl above are true, correct and e mplate to the best of my knowledge antl belief. /~ ~ HOME C 7/ 7 ) 737"`f~~.5 ~~'cv-~~ Gf~ - L-:~~~ WORK ( ) ' - i - ~ ... I ARI'ATtK stunAruK:E N/EL'S' TELEPHONE NUS ~~ ~ PNCBANK January 25, 2012 To Whom It May Concern, MILDRED A JACOBS was a joint owner on a checking account at PNC Bank with S THOMAS JACOBS and STEVONNA A COLEMAN as of the date of his (Thomas) death on December 2nd, 2011. The account number is 5112991374. Please contact me if you have any further questions. Sincerely, v Richard Wang Financial Sales Consultant PNC BANK Cedar Cliff Branch T 717-761-3291 F 717-730-0254 richard.wang(a~pnc.com PNC Bank -Leading the Way /t/~!L ~7/ZE O /~ ,r~CO X33 1 g 7~+c SPOUSE ar S Ti~aM/,1S .TACO3s j''~Vantnl/~ ~U(,EMA-N N~EcE ©F M'ILAR~ A f~ ~~CDl3S A member of the PNC Financial Services Group PNC Bank -Camp Hill, PA www.pncbank.wm ~, ~: ~~ Ik ~~ V.. P ~4 ~~ u~ 4: t~?' •~r ,~~ ~~ r '" ~ l1f AF{4L~ ~,'~rit,E ~ ~Qf2FE8-~ ~tRll~ 4~ pRptiA;N'S COt1r~T , J 3 a ~~ '_; 9 n 1 Q h w 0 J V 0 ~~ J Y i .Y TIM M ...: .w' ~~