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HomeMy WebLinkAbout02-21-12 (2) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE 7 ~ AND FILE I N0. 21 -~.~-'~~-~~~-~" BUREAU OF INDIVIDUAL TAXES Po Box z8ocol ~~~ ~~ I ;`. ~1jd~C~YER RESPONSE : ~ ACN 11107850 HARRISBURG PA 17128-0601 ~ , i , ~, y„' 1 ; , DATE 02-10-2011 REV-1543 E% AFP (Op ,A¢Y~',1 ~ ..`-~.~ TYPE OF ACCOUNT `d'~ ` "'~ ~ ( !~"1 ~' SJ EST. OF MARYANN 0 MYERS 1, L 3 L. © SAVINGS $$rj 164-22-8650 ~ CHECKING CL~R~ ~~~ DATE OF DEATH O 1 - 30 - 2011 ~ TRUST 0~~~r~'`t'~ rr~~j COUNTY CUMBERLAND ~ CERTIF. /~ 1.~1~~F~2k€~)~ ~P,i"~, l~\ ~ ~(~ REMIT PAYMENT AND FORMS T0: v DIANE L REGISTER OF WILLS CONNELLY 29 FAIRFIELD ST 1 COURTHOUSE SQUARE CARLISLE PA 17013 CARLISLE PA 17013 1ST FCU provided the Department with the information below, which has been used in calculating the MEMBERS cords indicate R that at the death of the above-named decedent, you were a Joint owner/beneficiary of this account. e potential tax due. feel the information is incor If rect, please obtain written correction from the financial institution, attach a copy to this form f lth you and return it to the above address. o This account is taxable in accordance with the Inheritance Tax laws of the Commonwea Pennsylvania. Please call (717) 787-8327 with questions. * SEE~~~EVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS COMPLETE PART I BELOW Account No. 361391-00 Date 07-07-2009 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 ~` I0 , 956.85 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 5,478.43 months of the decedent's date of death, ( .045 deduct a 5 percent discount on the tax due. Tax Rate ) Any Inheritance Tax due will become delinquent Potential Tax Due $ 246.53 nine months after the date of death. TAXPAYER RESPONSE PART FAILURE TO',RESPOND WILL RESULT IN AN OFFICIAL 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 check box "A" and return this notice to the Register of C H E C K Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be 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 indicatins a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX O~-N1 JOINT/TRUST ACCOUNTS PAD _ _ ~_,~ ,W,_ ______ LINE 1. Date Established 1 / U'l°o2~a°{ 1 2. Account Balance 2 '~ 1/~~Slo'g5 z 3. Percent Taxable 3 X •O /~ 3 4. Amount Subject to Tax 4 $ -~4"~ ~' 3 4 5. Debts and Deductions 5 - ~ 3'~ ~'~ 5 6. Amount Taxable 6 '~ '~ ~ ~ 6 7. Tax Rate ~ X ~ 8. Tax Due 8 '~ - d $ PART DEBTS AND DEDUCTIONS CLAIMED oAVGG DESCRIPTION AMOUNT PAID 1JAIt rAiu ^•~•- P~7USE 5 i / ~` ~ 5 0 a. d a 3~ i t i /~/ D 7i r~ S YUN/;Yla L l~im -~ ~ X /- /~ ~ •e •f" RAv~ AFAR Kt72 " '~ a ~' . SD 10 ~.2 1 Ll'Ru,J L E t~Y'~/~I AZ ~ iC~ x X %G ~(~ l 'f Under penalties of perjury, I declare that the facts I have reported above are true, correct and ~ ~, h '~~ complete the best f my knowledge and belief. HOME C /~ ~ ~Q`~ ~~`~ WORK (~/ ~ 7~t~' S~50~ Xo2/.3..1 /7 /vZ ~XPAYER SIGNATUR TELEPHONE NUMBER DATE Ewing Brothers Funeral Home, Inc. ~^ 630 South Hanover Street Carlisle, PA 17013- (717)243-2421 February 5,2011 Diane Ellis-Connelly 29 Fairfield St. Carlisle, PA 17013 The Funeral Service for Maryann O. Myers We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way eve can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES $I8-10.00 Services of Funeral Director/Staff , $875.00 Embalming, $290.00 Dressing, Casketing> Cosmo etc, 2. FACILITIES AND SERVICES $890.00 Complete facility usage 1 day 3. AUTOMOTIVE EQUIPMENT $275.00 Vehicle to transfer remains to Funeral Home, $250.00 Hearse (Casket Coach) $125.00 Utitlity vehicle for DC filing/retrieval , FUNERAL HOME SERVICE CHARGES $4545.00 SELECTED MERCHANDISE: $1725.00 ~~'ebster poplar casket $1295.00 #5 Regular Guardian OBC $10.00 Acknowledgement cards, $40.00 Register Book(s) . $75.00 Memorial folders , THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $7690.00 Cash Advances $550.00 Opening Grave. $42.00 Certified Copies of the Death Certificate , • $159.G0 Flowers. $101.78 The Sentinel no photo $40.00 Hairdresser (Dee Brookhart), $g92 78 TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total $8582.78 Total Cost , SUB-TOTAL INITIAL PAYMENT /DISCOUNT /CREDITS TOTAL AMOUNT DUE The unpaid balance over 30 days is subjected to a 1.50 % service charge per month - 18.0000 % per annum. <,~ ~G S~ ~ $8582.78 / e ~ c C ~-~, yy~ I 882.78 $0.00 ~~c~cou~ ~Z,7~ C~ ~ ~,/ ~~ ~~ i ~ ,~ ~ i ~~ ~~; Price Carlisle Memorial Service, Inc. DESIGNERS AND BUILDERS OF Cemetery Memorials 41 South Bedford Street Carlisle, PA 17013 Telephone (717) 243-5480 Total Price Please design and build the following memorial For Address _ Design No. Material - Die Base Markers _ Posts ____ Vases _ Price - Deposit Balance Due Tax Style of Letters Foundation to be furnished Material to be best selected mor manner. This memorial to be erected i unless unavoidably delayed by labor during the monm or troubles and other contingencies beyond our control and then as soon as possible. Additional lettering and other work on this memorial in the future is not included in the Contract Price. Title and right of possession and removal of said stone, monument or appurtenances shall remain for all purposes in Carlisle Memorial Service, nc. until work and materials ordered are fully paid by purchaser or purchasers. In consideration of the acceptance by Carlisle Memorial Service, Inc. of this order, the undersigned (hereinafter known as the purchaser) agrees to pay Carlisle Memorial Service, Inc• Dollars on or before the 15th day following the billing of the work or job upon completion thereof by Carlisle Memorial Service, Inc. Thirty (30) days from date of invoice a 1-1/2% finance charge will be added to the unpaid balance. Said billing to ~f m the s ace below byta du yf authorized eprelsentative of sa drCart see Memorial Serviceelncnd Carlisle Memorial Service, Inc. upon acceptance the P being understood that this instrument upon such acceptance covers all of the agreement between the purchaser and Carlisle Memorial Service, Inc. and that no agent or representative of Carlisle Memorial Service, Inc. has made any statements or agreements, verbal or written, mod'rfied or adding to the terms and conditions herein set forth. It is further understood that upon the acceptance of this order the co rteeme~ n writ na beotween the puc hasereand Ca isle' Memorial Serviceelncr 9 by any agent of Carlisle Memorial Service, Inc. in any manner except by ag urchaser or purchasers, twenty-five per cent of the total original and it is hereby understood and agreed by all parties involved that in case of default by p cost of the work or work and materials ordered, as the case may be, shall be a spec'rfied correct sum as liquidated damages which purchaser shall owe Carlisle Memorial Service, Inc. less any payment on account made prior to such default, this specification of damages to be due regardless of removal and taking possession of stone, monument or materials from purchaser or purchasers by Carlisle Memorial Service, Inc. upon following such dSEALI EAL) Date grade and to be free from imperfections and first class in every way. Work to be finished in a workmanlike Cemetery in or near Carlisle Memorial Service, Inc. Approval By White: Office Copy; Canary: Customer Copy; Pink: Salesman Copy; Gold: Deposit Copy W M C7 1 /1 1 2 a- N V1 /00 ~ a•M H ~O7 OOW~ •Z pp d•-•_100 O07 ¢VII~^O p ~~ 1 m2 ~o • ~: W ~ Q LL L1 ~ ~~~ ~~~ (h o r ~~~~ • ~~~ o r ~~ ea N N O W ti ... 2 h ~ O , \ ' \`1/ ``~~ \`J V ~l, ~ V '~\\ V ~~~ ~ ~ ~ J \~ ~ A,~ ~ r ~ ~ :.,~~rrfl~ eta ' ~.. i~i~v~.. ~~,,~~Y~-~da0 .i0 Y13~~ ~ ~ ~ ~ ,, ~ 1 i4i' ~ `~1`" '°;{ ~~ ~~~ ~~~ j~,~:~ e;t } ~,..~ re~`•