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Home My WebLink About04-03-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 015786 DECKER LINDA A 204 RIDGEVIEW RD NEW CUMBERLAND, PA 17070 ACN ASSESSMENT" AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: iss-~4-5130 FILE NUMBER: 2112-0404 DECEDENT NAME: DECKER WILLIAM J DATE OF PAYMENT: 04/03/2012 POSTMARK DATE: 04/02/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 01 /31 /201 2 REMARKS: SEAL CHECK#1427 12121094 ~ $154.19 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: 5154.19 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ' ~ PENNSYLVANIA INHERITANCE TAX ~~- , INFORMATION NOTICE FILE N0. 21 BUREAU OF INDIVIDUAL TAXES PO BOX 280601 eons ~V ''~-~ ,'r-~:''t HARRISBURG PA 171za-o6ol P y ~' >~PAYERNRESPONSE ACN 12121094 DEPARTMENT OF iEt~ ~ DATE 0 3 - 26 - 2 012 REV-1543 E% ~FP (05-I1) °~~l ~r~R _3 P~12: / i EST. OF WILLIAM J DECKER QR ~~E~ SSN K ~~ DATE OF DEATH 01-31-2012 Ct1~~f~ ~ ~~Rr COUNTY CUMBERLAND ~.,~} ~~ REMIT PAYMENT AND FORMS T0: LINDA A DECKER REGISTER OF WILLS 204 RIDGEVIEW RD 1 COURTHOUSE SQUARE NEW CUMBERLAND PA 17070-2847 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SUSpUE HANNA 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 Sp0U5e 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. 5400192009 Date 08-06-2008 To ensure proper credit to the account, two Established copies of this notice oust accowpanv 0 55.8 3 pavwent to the Register of Wills. Make check Account Balance $ 2 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax paywents are wade within three Amount Subject to Tax $ 1 ~ 027.92 months of the decedent's date of death, Tax Rate ~( , 15 deduct a !5 percent discount on the tax due. Anv inheritance tax due will becowe delinquent Potential Tax Due $ 154.19 nine nontlhs after the date of death. P~T TAXPAYER RESPONSE 1 FAILURE TO RESPOND WILL R M OFFICIAL S A. ~ The above inforwation and tax due is correct. Rewit 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 assesswent will be issued by the PA Department of Revenue. BLOC 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 inforwa ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART 3~ 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 +~ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, co'r`rect an/d cq~nple//te to``theJ best o/f my~ knowledge and belief . HOME C '7/ 7 ) 7~~7 ~ ~ 7(O Y/l~~lJ A_ i( .('%Gi/ WORK C ) ~ o~ ~~ P YER S GNA URE TELEPHONE NUMBER AT TOTAL (Enter on Line 5 of Tax Computation) 6 nF'~~ 1 ,~11 .~7j ~~ y7'' Y 3 ~' 1 .~ '~ r'. ~,. ~'~. ~`=. ~~ Q ~a.f r~.. S.F~ ~• ~' ~~ ~~ ~ `~ -. , ~~ --t ~~,~ Lei dd ~~z:: c .~i~~:.'~~~BWiI~.~ o ~ ,~ lances ~::~,,,~ . ° ~o ~a~~~ ~ti a ~ ~ ~~ ~ qb~ ~ i ~ZI ~~ E-- ~~'`~ ~',lOl a ~~ 3 :J f , ! `~ Z 1\ i~ll~~~~ V ~~~~ I' .. .. . , ~i~J ~~ ~~