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Home My WebLink About02-24-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PLESCE TERESA A 254 E MAIN STREET SHIREMANSTOWN, PA 17011 fold ESTATE INFORMATION: SsN: ~ 84-12-3200 FILE NUMBER: 2112-0230 DECEDENT NAME: WARD RAMSEY L DATE OF PAYMENT: 02/24/201 2 POSTMARK DATE: 02/23/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 02/06/2012 ACN ASSESSMENT CONTROL NUMBER AMOUNT 121 10854 ~ S 10.00 TOTAL AMOUNT PAID: REMARKS: CHECK# 10.00 SEAL INITIALS: CJ RECEIVED BY: S 10.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 N0. CD 015625 REGISTER OF WILLS JJ•~~ Liz BUREAU OF INDIVIDUAL TAXES ,,,{{{~~~,,, PD BDX 280601 penns~~c HARRISBURG PA 17128-0601 DE PARTMEN FI REV-1543 EX PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21-"/',~ -G~:~"~C:: .j~ti_`~~~~ AND ACN 12110854 '. ~ ;.~XPAYER RESPONSE DATE 02-15-2012 ' 1~ ~.`~f 1~~~"Z ~~~ Z~F ~~ ~~~ ~ 1 CLERK r~ ORPH~~,N`S COI.lRT TERESA A PLESCE 254 E MAIN ST CAMP HILL PA 17011-6314 EST. OF RAMSEY L WARD SSN 184-12-3200 DATE OF DEATH 02-06-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FDRMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 farm and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 70830-11 Date 09-08-1997 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 1 332.99 ~ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to TaX $ 222.17 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 $ lU 00 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFF ICIAL TAX ASSESSMENT A. I.i( The above information and tax due is correct. LJ Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K 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 Revenue. 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 filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFICIAL USE t3NLY [~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 +fi Z 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S 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. unMG ~ ~ aanaaoi ss~.~_~s~cl~ vsn > R:"~ .°w " _ . ~~ p~- \1 .y,_. i'^ ~~ vJ UI ~ j ~w ~ S ~' `~ ~, ~-- ~~ .~ ~~ V ~~ r n L~-~.-, J ~ ~ ~ ~.- j ^ ~ ~~ ~JF~ s 4 9 4 1 .. ^ ~I ~L~ `J i~ i r^ ~jV` ,,: J I f~l - ~` ~-~-i ~Q ~~l~LL~,.1 ~, ;_;.,~ ,t ~ ., i~ ~~~ t': ~~} !.~ i'1 .~ ~F }1h Z .r.{