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HomeMy WebLinkAbout04-02-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NORTON ALISA M 2 THYME COURT MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: ssN: i 98-3o-i 27 s FILE NUMBER: 2112-0246 DECEDENT NAME: WALLACE SHIRLEY ANN DATE OF PAYMENT: 04/02/2012 POSTMARK DATE: 04/02/201 2 couNTY: CUMBERLAND DATE OF DEATH: 02/ 1 3/201 2 REV-1162EX~11-96) NO. CD 015776 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12113544 ~ $31.44 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY CHECK#1181 SEAL INITIALS: DMB 531.44 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX ~~n(`~ ,; 1f~t~~ BUREAU OF INDIVIDUA~~f11 ~ .;!:'',, ~ . INFORMATION NOTICE /_ FILE N0. 21 - ~ a J~yu , PD BOX 280601 - ~/8~'lld per'1l1~1~ AND ACN 12113544 },..• ~ HARRISBURG PA 17128-7R'u~~P.. , ,--DEPARTMENT OFREVENUE TAX P AY E R R E S P O N S E DATE 02-23-2012 REV-1543 EX APP (05-I1) _. 1.{~~ f§i i\ r CLERK JF ORPH~kPd' ~~ 0~ T CU~~~~~":. ~ P PA ALISA M NORTON 2 THYME CT MECHANICSBURG PA 17050-3199 EST. OF SHIRLEY A WALLACE SSN DATE OF DEATH 02-13-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE 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 yoD 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 returr) 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. 246254-1 1 Date Ob-16-2004 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 , 397.49 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 698.75 months of the decedent's date of death, TeX Rate )( .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $` 31 • 44 nine months after the date of death. PART TAXPAYER RESPONSE ~ fiE TU~ FF~,~,i: , TENT WILIS, A. `~.[~ The above information and tax due is correct. 1~ 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 an official assessment will be issued by the PA Department of Revenue. C ONE 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 informs ion 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 ONLY ~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 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Taz 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 lln a altieJs/Of perjury, I de Tare that the facts I reported above are true, orrect an om tq; the/byes~t of1m~know edge and belief. HOME C ~ ? r ~~~ DA TOTAL (Enter on Line 5 of Tax Computation) S