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HomeMy WebLinkAbout02-16-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: FROELICH INA V 300 RIDGE ROAD LOT 109 ETTERS, PA 17319 -------- faia REMARKS: SEAL CHECK#1670 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER TOTAL AMOUNT PAID: INITIALS: CJ RECEIVED BY: REGISTER OF WILLS AMOUNT 537.50 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 015598 ~, PENNSYLVANIA INHERITANCE TAX ~' INFORMATION NOTICE FILE No. 21-i~~~-~G~I~; BUREAU OF INDIVIDUAL TAXES r~--.^, r AN D Po Box 260601 p@n ~~ ,~ 14„~~ ~ ACN 12107285 HARRISBURG PA 17128-0601 DEPARTME RF~vEOw~, ,,r~~ ~ c! TAXPAYER RESPONSE DATE 01-31-2012 REV-1543 E „IkE.P-i'(05 irll')~ ""'1, ti~i2 i~~.~ ! 6 PFD i ~ 01 {~CLAEAR~; Cr Ofl~t'Ju`i1vI1~ ui~~T GERALD C FROELICH TRLR 109 300 RIDGE RD ETTERS PA 17319-9338 EST. OF MARY R FROELICH SSN 202-20-0112 DATE OF DEATH o9-13-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS © CHECKING TRUST CERTIF. SOVEREIGN 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. C(1MPIFTF PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1661216005 Date 10-30-1995 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 500.02 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are-made within three Amount Subject to Tax $ 250 • O1 months of the decedent's date of death, l deduct a 5 percent discount on the tax due. Tax Rate ~( , j Any inheritance tax due will become delinquent Potential Tax Due $` 37 • 50 nine months after the date of death. TAXPAYER RESPONSE PART FAILURE TO RESPOND WILL RESULT IN AN OFF ICIAL TAX ASSESSMENT A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and C H E C K an official assessment will be issued by the PA Department of Revenue. ONE B L 0 C K C 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 ~ and/or PART ~ below. PART 0 TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS iPAD 1 2 3 X - - - -: ~- _ . _- 4 $ _ _ _ 5 6 `~ 7 X 8 OFFICIAL USE ONLY ~fAAF PA DEPARTMENT OF REVENUE 1 2 4 5 6 7 6 PART •rn PAVGF DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID ~F..F;nnl S Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of m knowledge and belief. HOME C ~~ ~ j i( / WORK C ? ~, TAXPAYER SIGN TURE TELEPHONE NUMBER ATE If indicating a different tax rate, please state relationship to decedent: USA Fl 4LASS FOREVER D01 ~`) r E y„ +lf Gnu. i1. T~ r^1 ~'S ~'' '~ e-1 ~~ ` - f, . `~ , t~ t.~. ~• ~ ~ o 1\ ~ 11. v 0 ~ Q,~q v ~: ~ ~~ t1d ' U:i Ci~dl 1~f14~ S~NtlHdl~ ~~ x~~ ~ o : t ~~ s i ~~ ~~~ a +` 1 S~i c f~ y -:~ , .~~~~ ~Q 3~~~ : ~a~~~~~~j ~