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Home My WebLink About03-19-12GQMMQNW~ALTH QF RENNSYLY9NIA REV-1162 EX(11-96i @EBAAT~.IENT pF R~yENUE 9UA8A,U OF INp1YIDUAL TAXER f1EPT. 26P$t~l FdA?F1158Ub1Sa, BA 1~12$•QBpa PENNSYLVANIA REDEIVE6 FROM: INHERITAPICE AND ~Si'ATE TAX OFFICIAL RECEIPT N0. C~ Q15~~1 ~~AU~~~ 1`bOMAS ~ 107 W COOVER STREET MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL. NUMBER -- - Ipld -..._.__._ ESTATE INFORMATION; SSN: 307-32-8653 FILE NUMBER: 211 2=0124 DECEDENT NAME: KRAUSSE JEWELL M DATE OF PAYMENT: 43/19/2012 POSTMARK DATE: 03/17/2012 COUNTY: CUMBERLAND DATE OF DEATM: 01 / 17/2012 REM~-RI~S: SEAL C~dECK#~ 17~ 1210$740 ~ $457.73 TOTAL AMOUNT RAID: INITIAL: DMA RECEIVED BY: X457,73 GLENDA EARNER STRASBAUGM REGISTER OE WILLS REGISTER QF WILL~v ~._ PENNSYLVANIA INHERITANCE TAX BUREAU DF INDIVIDUAL TAXES , ~ ~~ INFORMATION NOTICE ~~ ~~`~~' ~ ~ AND FILE N0. 21 -` ~ - ~~~ PD Box zaocol ~~,~~Y~~ 1 ACN 12108740 HARRISBURG PA 17128-0601 ~p~J-iENYbPR$VEf~'._,'.~ TAXPAYER RESPONSE DATE 02-06-2012 REY-1543 E% AFP (05-I1) ~~~2 P~~R ! 9 PMI !2~ 0 I CLERK 0~ C~R°HAN'S Dui l~T CIJM~.~~! 1~~1`~ C~~ FA EST. OF JEWELL KRAUSSE SSN 307-32-4553 DATE OF DEATH 01-17-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: THOMAS KRAUSSE REGISTER OF WILLS 107 W COOVER ST 1 COURTHOUSE SQUARE MECHANICSBURG PA 17055-6434 CARLISLE PA 17013 TYPE OF ACCOUNT ^ savlNGs ^ 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 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. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 15988 -48 Date 04 - 11 - 1974 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 10, 149.57 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to TaX ~` 10, 149.57 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X . 045 deduct a 5 percent discount on the tax due. Potential Tax Due Any inheritance tax due will become delinquent $ 456.73 nine months after the date of death. PART TAXPAYER RESPONSE LU R D I R U I N FIC NT A. ^ The above information and tax due is correct. 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 0 N E an official assessment will be issued by the PA Department of Revenue. [ B L 0 C K ~ 0 N L Y B. ^ The above asset has been or will be filed by the estate representative. reported and tax paid with the Pennsylvania inheritance tax return C. ~ The above informs ion is incorrec,t Complete PART 2~ and/or PART 3LJ and/or debts and deductions below. were paid. PART it indicating a different tax rate, please state ~~'~ ^~ ~ ~ ~ relationship to decedent: ~ ~ ~ ~F;IC L~SE~ O~ ~ `~~ PA DEPARTMENT AF REVENUE TAX RETURN - CALCULATION OF p T X ON JOINT/TRUST ACCOUNTS AD °~ LINE 1 . Date Established 1 L ~ 1 r9 ~') ~'°~7 ~ ~~ 1 2. Account Balance 2 $ ~ n ~ 5Q ~ ~p 2 3. Percent Taxable 3_ X 1 f~0 .~~ 3 \ 4. Amount Subject to Tax 4 _ $ ~ ~ a<5Q ~~ ~~~ {y \ 5. Debts and Deductions 5 - 5 ~ 6. Amount Taxable 6 $ ~~ S , 3 0 6 7. Tax Rate 7 X ~ ~ ~~ 5 ~ '~ 8. Tax Due 8_ $ ~ 5 ~ ~ 73 ~; .-ter .~' PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMniiuT nwrn Under penalties of perjury, I declare that the facts I reported above are true, [correct and complete to the st of my ~ y~ and belief. HOME C ~I~ ) 7p~ ~ ~,~~~~ WORK C - ) ~~--I - I I;`I~L~ TA PAYER SIGN. URE TELEPHONE NUMBER DATE ~~«~ ~~~ amine ~ yr rax ~ompuiation) $ r~ ~ i h,_ ,~' ~ '-'~ ~ .1 '_ -~ ~ L v d _ ~ 99~ t~9 ~ -.. - ~~ C p ~ C°,, ~ ~ ~~ ~ ~ ARK. ~` CtJMBFp' - . ,., a. ~ -, ~ ~ ,.5 ~~ n ~- d: a. ~ ~ .~ L ~ ~^ ~~ 1, ~r 1 ~~ -~.. V {.j t~F t {rj :d;F l',' .~ {~t a: F" •rd