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Home My WebLink About02-13-12COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 2 8-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015585 MURPHY LOUISE 9299 MOUNTAIN RD GRANTVILLE, PA 17028 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: 2oi-is-8466 FILE NUMBER: 2112-0193 DECEDENT NAME: SHAULL DORIS B DATE OF PAYMENT: 02/13/2012 POSTMARK DATE: 02/10/2012 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /08/201 1 REMARKS: CHECK# 6397 SEAL 12107857 ~ 555.15 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: REGISTER OF WILLS 555.15 GLENDA EARNER STRASBAUGH REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 260601 HARRISBURG PA 17128-0601 Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX AFP (05 -11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 ~~' ~~~ AND ACN 12107857 TAXPAYER RESPONSE DATE 02-02-2012 LOUISE K MURPHY 9299 MOUNTAIN RD GRANTVILLE PA 17028-9321 EST. OF DORIS B SHAULL SSN 201-16-8466 DATE OF DEATH :L1-o8-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQIIARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. M & T 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-P+~~fMENT INSTRUCTIONS Account No. 77214463 Date 08-28-1964 To ensure prooer credit to the account, two Established copies of this notice oust accompany Account Balance $ 2, 451.31 aayment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax vayments are made within three Amount Subject to Tax $ 1 ~ 225.66 months of the decedent's date of iddath, Tax Rate X .045 deduct a 5 percent discount on th~tax du Potential Tax Due $ Any inheritance tax will beco~.~7^~delir(~6' 55.15 nine months after t~ of deatr~,•i r;a PART TAXPAYER RESPONSE ~ _ {~~~ Al~tllt~ T~,~RES~?OliD~.14Xk3' R ULT; I#i AN. '(if>rICSAL TA~AB~>s ~ W _, ;~ A. ~ The above information and tax due is correct. ")~ Q ~ ~' Remit payment to the Register of Wills with two copies of this notice to obta}LCj ~"7 ~'" C H E C K a discount or avoid interest, or return this notice to the Register of Wills~~ L,y Y"~ C 0 N E ~ an official assessment will be issued by the PA Department of Revenue. _ .~ ~=~ ^Q N ~ BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania i~eritance ta3(r return O N L Y filed by the estate representative. C. ~ The above informs ion is incorrect and/ar debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, Please state rOf~I~L~-L $J~1= bbILY ~ AAA relationship to decedent: - r,<; g TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS pA~': LINE 1. Date Established 1 'i ` " ~` 2. Account Balance 2 $ 2 ` ~' a~ 3. Percent Taxable 3 X ~ " `~' ~ ' 4. Amount Subject to Tax 4 $ {r. ~~ 5. Debts and Deductions 5 ~` ''~ 6. Amount Taxable 6 $ b '`~~" 7. Tax Rate 7 X 8. Tax Due 8 $ $ =' '' PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct anpd complete to the best of my nowledge and belief. HOME C 7I ~ ;~ y~p~)~05 / WORK C 7/7 '~o? -~ TAXPA ER SIGNAT E TELEPHONE NUMBER DA TDTAL CEnter on Line 5 of Tax Computation) S ;:~x ,,._, `KY 'µ ;;j~ 'iii :, ,,,.~. :~r Ny '~:J. ;. '~, 4: ~: ;- ~:. ~~' 4' u.- ~:.. L ~ ~\ b j o ., ~ ~~ ~ p, ~ ~ j ~. °~'' ~ a N ~}t tra !3 } i'~ i .,.., j,4 .p'1 t ~~ ~,