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HomeMy WebLinkAbout04-19-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0 601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX~11-96) NO. CD 015870 MERRILL KATHLEEN A 2160 CANTERBURY DRIVE MECHANICSBURG, PA 17055 told ESTATE INFORMATION: SSN: 1s2-38-2179 FILE NUMBER: 2112-0463 DECEDENT NAME: MERRILL GREGORY DATE OF PAYMENT: 04/ 1 9/201 2 POSTMARK DATE: 04/19/2012 couNTY: CUMBERLAND DATE OF DEATH: 12/07/201 1 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 11183188 ~ 56.07 TOTAL AMOUNT PAID: 56.07 CHECK# 3775 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS j PENNSYLVANIA INHERITANCE TAX BUREAU DF INDIVIDUAL TAXES I N F O R MAT I O N N O T I C E ~ -s (r~rr ~~}r~^ Po eox 2ao6o1 FILE HARRISBURG PA 17128-0601 ~ ~~~ `~`- "' AND DEP~FME'~J{qF REVENUE °;;{ ~ TAXPAYER RESPONSE aCN f~ l.( ;; REV-1543 EX AFP (OS-11) ' DATE 'a:: ~ 2 ~~R 19 F'i~ !~~ 15 CLERK C~ ORPHAN'S COl)RT Ct~A~~~;~~ AP{~ {';n pq ALEX MERRILL 2160 CANTERBURY DR MECHANICSBURG PA 17055-5767 $ 809.19 X 16.667 $ 134.87 X .045 $ 6.07 TAXPAYER RESPONL Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK ONE BLOCK ONLY PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE I. 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 PART 0 -~ uace 02-24-1997 Established OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 - 6 7 X 8 N0. 21 ~ ~~ ~i`[IDJ 11183188 12-21-2011 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. -~. av,~J To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. FAILURE TO RESPOND WILL RESJ.U..T IN AN OFFICIAL TAX ASSESSMENT A• ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain andofficialoassessmenttwilltbeoissuedrbytthe PAtDepartment ofgRevenuef Wills and 8• ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax ror,,..., filed by the estate representative. C• ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART L__I below. OFFICIAL USE~ONL ~ FAA PA DEPARTMENT OF REVENUE PAD 1 2 3 4 _ 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION TOTAL (Enter on Line 5 of Tax Computation) Under penalties of ~ perjury, I e are that the facts I reported above are true, correct and o pl a to t e t of my. k se and belief. HOME (~'~ ~ ~ ~ 9 ~ , ~ 18oZ TAXPAYER SI u F WORK ( ~ EST. OF GREGORY MERRILL SSN 182-38-2179 DATE OF DEATH 12-07-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 MEMBERS 1ST FCU Records indicate that at the death of the above-named decedent. provided the department with the information below, which was used in calculating the inheritance tax due. You were a joint owner/beneficiary of this account. If deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but notify the department of your relationship to the deceased by checking Box C in PART 1 below and writin you are the spouse of the If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy'to this form and re it to the above address. Please call 717-787-8327 with 9 Spouse" in PART Zust COMPLETE PART 1 BELOW * Questions. turn SEE REVERSE SIDE FOR FILING AND PAYMENT TAIL TOI,r r:....~ Account No. IALO7z_nn DATE PAID PAYEE ~~~ °~ ~~ -_,. ~' Q • ~~ ~~~ (;t i t'1 ~ `7 ~_} •r•1 ~...~ .r..f t. U .o x 3' = R: ~ a ~~~ U ~a Pr ~ i 4tip ~, dt~ ~ ~~~- a• !J r~ ~~{~j s