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Home My WebLink About04-02-12COMMONWEALTH OF PENNSYLVANIA DEPARLMENT OF REVENUE y BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: COULSON DELORES J 616 HIGHLAND AVE CARLISLE, PA 17013 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 015788 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: ssN: 173-o~-55s~ FILE NUMBER: 2112-0393 DECEDENT NAME: COULSON GEORGETTA J DATE OF PAYMENT: 04/03/2012 POSTMARK DATE: ---E~~~@3~ZU1 2 ~ ~' ~ Z~)C~'~,~ COUNTY: CUMBERLAND DATE OF DEATH: 03/19/2012 REMARKS: CHECK# 7713 SEAL 12122518 ~ 5228.33 TOTAL AMOUNT PAID: INITIALS: HEA 5228.33 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~ BUREAU OF INDIVIDUAL TAXES ~ PU BDX 288601 Pen~~~t."~ DEPARTM~T-Or RE~tlE HARRISBURG PA 17128-0601 :}3- REV-154 ~E7(i~~'(b5•ln ~' PENNSINFORMATIONENOTICEE T ;_r.,,.~ „` AND ~,`~~'~ ~1` TAXPAYER RESPONSE ~r. . _ 1-' J a S..i ~S. CLER'~ CF ORP~i~~`~`~ ~~~~~~T CtJ~"~'r_~s'._;a"~.~~ Chi , PA ~; SUANN KNOUSE 20 E COUNTRYSIDE DR BOILING SPRINGS PA 17007-9720 FILE N0. 21 ACN 12122519 DATE 03-30-2012 EST. OF GEORGETTA J COULSON SSN 173-01-5587 DATE OF DEATH 03-19-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. provided the department with the information below, which was used in calculating the ,nhbut ay oU mUStue. indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If yoU are the Spouse 0 e MEMBERS 1ST FCU note no tax may beodSe„ in PART 2. s reflected below on the PotentiXlCTin PARTllnbelow and writing " to this form and return Records Checking BO deceased and any amount othoU~ relationship to the deceased by notify the department of y lease obtain written correction from the financial institution, attach a P If you believe the Information is incorrect, P it to the above address. Please call 717-787-8327 with questions. nr~ nW aR SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONccount, two COMPLETE rwR ~ Y~---- ' °°-~ -- Date 10-25-20 To ensure Account No. 157273-58 copies of this notice must accompany Established payment to the Register of Wills. Make check - ter of Wills. Agent". PART 10 , 148.15 payable to Rests Account Balance X 50.000 NOTE: If tax Payments are made within three dent's date of death, percent Taxable ` 5,074.08 months of the dece ercent discount on the tax due. 5 Amount Subject t0 Tax $ , 045 P deduct a Anv inheritance tax due will become delinquent Tax Rate X 228 , 33 nine months after the date of death. Potential Tax Due TAXPAYER RESPONSE IN AN OFF ICIAL TAX ASSESSMENT FAILURE TO RESPOND WILL RESULT A, The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain andoffocial assessmenttwilltbeoissuedrbvtthe PAtDePartment ofgRevenuef Wills and The above asset has been or will be reported and tau Paid with the Pennsylvania inheritance tax return B. filed by the estate representative. d CHECK ONE C BLOCK ONLY C, ~ The above informs land/or1PART re~ belowr debts and deductions were pal Complete PART 2~ ,-r(.T n: IICF f1N1_Y i t AAF a different tax rate, please state PART If indicatin9to decedent: relationship TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 2 2. Account Balance X 3 3. Percent Taxable 4. Amount Subject to Tax 4 5. Debts and Deductions 5 $ 6 6. Amount Taxable X 7 7. Tax Rate $ 8 PART 0 DATE PAID DEBTS AND DEDUCTiuna ~ PAYEE PA DEPARTMENT OF REVENUE PAD 1 3 4 5 6 8 LAIMED DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury'knowled9eeandabelieffacts I reported above are true, - , HOME C ~ C,~,O comp to to the best of my WORK C ~ ~~ /YLC~~~~ TELEPHONE NUMBER ATE _ __...runr .