HomeMy WebLinkAbout02-22-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
WEBER THOMAS E
BOX 68
GRANTHAM, PA 17027
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssrv: iso-2o-6386
FILE NUMBER: 2112-0236
DECEDENT NAME: WEBER NORMA E
DATE OF PAYMENT: 02/22/2012
POSTMARK DATE: 02/21 /2012
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 14/201 2
REV-1162 EX(11-961
NO. CD 015611
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
12108693 ~ 58.09
TOTAL AMOUNT PAID:
REMARKS:
CHECK#150
SEAL
INITIALS: HEA
RECEIVED BY:
58.09
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 260601
HARRISBURG PA 17126-0601
d~
REY-1543 EX
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21
~~~~'. ~~`C,E~Q~ AND ACN 12108693
~;;,~~ TQAXPAYER RESPONSE DATE 02-06-2012
CLERK Qr
ORPH~N 5; C~0 ~~~pA
CIIM~. ,
THOMAS E WEBER
PO BOX 68
GRANTHAM PA 17027-0068
EST. OF NORMA E WEBER
SSN 180••20-6386
DATE OF DEATH 01-14-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQl1ARE
CARLISLE PA 17013
TYPE OF ACCOUNT
^ SAVINGS
® CHECKING
TRUST
CERTIF.
MEMBERS 1ST F CU 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 an 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 PAYMENT INSTRUCTIONS
Account No. 40481 - 1 1 Date 08 -11 - 1984 To ensure proper credit to the account, two
Established copies of this notice oust acoanaarry
Account Balance $ 359. b7 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are ^ade within three
Amount Subject to Tax $ 179.84 months of the decedent's date of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 8.09 nine months after the date of death.
PART TAXPAYER RESPONSE
~ ~~; :;' ;~~axi:~~i~~s `Try-F~~t'o~r~'~~.A~~r~-x..~ss~ss N".
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or return this notice to the Register of Wills and
C 0 N E ~ an official assessment will be issued by the PA Department of F:evenue.
BLOCK 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 wer4r paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state ~~
``'~QF~~ . ~ UHF
ON~.Y
relationship to decedent: .
._
'
~
2
^ . ? PA'' ALi'~~'~~xr.OF REVENUE
TAX RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 ~, "''""'
2. Account Balance 2 +fi 2
3. Percent Taxable 3 X 3 `u ~ „"s~~f , i4
4. Amount Subject to Tax 4 $ !f
5. Debts and Deductions 5 - ~
6. Amount Taxable 6 $ {
7. Tax Rate 7 X
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of my knowledge and belief. HOME C )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
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TOTAL CEnter on Line 5 of Tax Computation) S
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