HomeMy WebLinkAbout05-07-12 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
SHORT WILLIAM M
71 SMITH RD
NEWVILLE, PA 17241
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ESTATE INFORMATION:
FILE NUMBER: 211 2-0532
DECEDENT NAME: MICHELSON MURRAY E
DATE OF PAYMENT: 05/07/2012
POSTMARK DATE: 05/04/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 03/29/2012
REMARKS:
CHECK# 616
SEAL
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 015944
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
12128707 ~ $48.24
TOTAL AMOUNT PAID:
INITIALS: HMW
$48.24
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE
,,1 INFORMATION NOTICE
pennsyly~ ~a - _ F,f',c ~ AND
oEPnarMENTOFaEV , '=' T,AYER RESPONSE
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REV-1543 E% AFP (OS-11) ~ - ~-'1
TAX
FILE N0. 21 "~2~/~G-
ACN 12128707
DATE 04-30-2012
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GREGORY R WILLIAMS
122 CAMBRIDGE DR
MECHANICSBURG PA 17055-3560
EST. OF DONNA B WILLIAMS
DATE OF DEATH 03-12-2012
.COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA 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 y0U 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 IHSTKUCTIONS
Account No. 5130051685 Date 01-29-1990 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 6 ~ 770.00 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667 -----
NOTE: ax payments made within th
Amount Subject to Tax $ 1 ~ 128.36 month of the decedent's d to of death,
Tax Rate )( .045 deduc 5 percent disco t on the tax due. ~
Potential Tax Due $ Any in - e will become delinquent
5 0 • 7 8 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. IiYThe above information and tax due is correct.
L~J 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 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 IJ and/or PART 3^ 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 +fi 2
3. Pcrcect Taxable ? X 3 .~-._ _. _ ~_-___~_ _~
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
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
Under penalties of perjury, I declare that the facts I reported above are true, correct and
cdhip ete to tthe basest of my owledge and belief. HOME C 7~~) ~g~~
~~ ~~'~~1~'L"~`Y Y'~ . L~. ~. _~_)C ~(R!'t.M~A,, W O R K C '] 1 7 ~ a~ ~3 ~-f - U ~
s ~-~~
DATE
TOTAL CEnter on Line 5 of Tax Computation) S