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Home My WebLink About03-05-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0601 RECEIVED FROM: YOUNG CONSTANCE S 180 RIDGE DRIVE CARLISLE, PA 17015 told PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: iso-o5-ass FILE NUMBER: 211 1-0666 DECEDENT NAME: DOPSOVIC THERESA DATE OF PAYMENT: 03/05/201 2 POSTMARK DATE: 02/22/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 05/19/2011 REV-t 162 EXIT 1-961 N0. CD 015659 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11180120 ~ 562.16 TOTAL AMOUNT PAID: REMARKS: 562.16 CHECK#176 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER pF WILLS ~icn FIRST-CLASS FOREVER !,'~33 ~.r i'i t r e r~ j s~.,,~ ~ .~ ._i •t't{ i..! a: i ~1::!~ N ~ r~ '.1 ~ rf ~' . ~~; : ~. ;;rl ~ ~ -_ ~ J ~~. ~ ~ ~' ~ N pC. r'~ N `~y Q '- v O ~:~- : ~~ ~ _, ~~, O \`V \\ \~ i.t .. i~ <..~ 4 ~ ~ ~~~c~. ~ ~ ~- ~~ ~ ~ ~~ ~ ~ ~'' ~~ \ ,,..t ~; ; `} ti~ ti~•~ .r.J .;~i .. ?~ ~_. __ a T v. /~ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 D~Qe~~~.~(~~ HARRISBURG PA 17128-0601 ~~Ll:/,_itT1.~;-, FP o~'~~:'~' PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0666 ~~ TAXPAYERNRESPONSE ACN 11180120 IC DATE 12-08-2011 ., ~ f ~~=il ~°~~R -5 F~ 1~~ Zip C~ER~, v~ ORPHr~AN`SLL,, ~ ~C~TPA, r' ~~~(~~t'1~ ;hilY. THOMAS J DOPSO"0~~"C "` 180 RIDGE DR CARLISLE PA 17015-9711 EST. OF THERESA DOPSOVIC SSN 16iD-05-8196 DATE OF DEATH o5-19-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SI~UARE CARLISLE PA L7013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SOVEREIG N 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 deppartment of yowr relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe fhe information i$ 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 $ELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 04511'5549 Date 05-04-2009 To ensurn proper credit to the account, two Established copies o~F this notice must accompany Account Balance $ $28 7$ Payment Ito the Register of Wills. Make check payable Ito "Register of Wills, Agent". Percent Taxable X 50.000 414.39 NOTE: IMF tax payments are made within three Amount Subject to Tax ~` months o1F the decedent's date of death, Tax Rate ~( , 1[j deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 62.16 nine months after the date of death. PART TAXPAYER RESPONSE Ra` ~ P~#117` i ~ES» . I!t _atl FF r s A. ~ The above information and tax due is correct. Resit 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 an official assessment will be issued by the PA Department of Revenue. t ONE B L 0 C K -, B. ~ The above asset has been or will be reported and tax paid with th~z 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 wei^e paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: 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 1 2 3 X 4 5 6 7 X 8 $ .. FTIA~~ U ONLI [~~AAF PA DEPARTMEi+IT DF REVENUE PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under ens s f perjury, I declare that the facts I reported above are true, correct and /1 com ete o h est of my knowledge an belief. H OME C ) .-~ ~fLY/ C WO R K ( ) S TURE TELEPHONE NUMBER DATE :uinL ctnter on Line 5 of Tax Computation) # r , ~ I•tpJ 4:;7 /~~~~ 'v ~ .yl "' _ E ~.' ~rV~hfl, ~ ~ ire ~ d ,g o a ~? o ~:z ~ ~ ,>~~seN 8$1-'f9181i1d ~~~ ~ N N ~ ~~ ~ O C_ ~ 1 ~,} ~~ ~ CO LT ~-:.; :} -„ ...~ .~::, ..... .... .~: .«~. ,:.. ~.. ~.: ~.~, .~.... /~ i_ ' G ~~ 1~ rr h ~1~• rT R ~ C wH,~a ' ~ ~ ~ ~ ~~°~°~ N ~ H _~ ~~~~ x a~ax ~'._. _ t ~ rn ~ ~ o ca L ~ ~ N y ~ ~ Uo in ~,/NE L y L.L C r c`o•~U ~~ -a ° m'oQ ~_ a ~,~~~~ a~ E ~ '~ ~m~Uco ~~U~U