The URL can be used to link to this page

Home My WebLink About05-24-12BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17129-0601 EX XFP (OS-111 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ) ~ 'S~ 2 ACN 12129468 DATE 05-03-2012 i~a12~AY 2~+ ~~i tI 10 ' ^~ UPyP#irJ'd ~ 'vUUrj CUMBE..RLPJXID DO . PA SANDRA L BROWN PO BOX 47 DAUPHIN PA 17018-0047 EST. OF ETHEL L KNAUB DATE OF DEATH 03-08-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MID PENN BK provided the tlepartment with the information below, wM ch was used in calculating the inheritance taz due. kecorda indicate that at the death of the above-named decetlen t, you were a joint owner/beneficiary of this account. If y0U dre the BpoUSe 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 deoa rtment of your relationship to the deceased by checking Box C to PART 1 below and writing "spouse" 1n PART 2. If you believe the information is incorrect, please obtain written correction from the financial institution, attach a coDY to this form and return it to the above atltlress. Please call 717-79]-9327 with nuesti ons. COMPL ETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILIN6 AND PAYMENT INSTRUCTIONS Account No. 8012825 Date 07-01-1998 To ensure proper credit to the account, two Established conies of this notice oust accompanv Account Balance 96 paYnent to the Register of Wills. Make check 762 S . paY able to "Register of Wills, Agent". Percent Taxable X 50.000 Amount SubjaeY to 48 NOTE: If tax payments are node within three Tax S` 38 1 ' . nonths of the dacetlent s date of tleath. Tax Rate X . 045 deduct a 5 percent tli scount on the tax due. Potential Tax Due Arar inheritance tax due will becone delinquent ~` 17.17 nine nonths after the date of tleath. PART TAXPAYER RESPONSE 1^ A. ~ Tha above infornation antl tax due is correct. Resit paYmenf to the Register of Wills with two copies of this notice to obtain C HEC K a tli scount or avoitl interest, or return this notice to the Register of Wills antl ONE an official assessne nt will be issuatl by the PA Departnent of Revenue. BLOCK B. ~ The above asset has been or will be reported antl tax Daitl with the F'ennsvl vents inheritance kax return ONL Y filatl by the estate representative. C. ~ The above infore~a ton is incorrect and/or debts and deductions were paitl. Complete PART IJ and/or PART ~ below. PART If indicating a different tax rata, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 PS 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 S Untler penalties of perjury, I declare that the facts I reported above are true, correct complete to the beck of my knowledge and ballet. unur rl/1/1 . ~ A / D WORK C ) PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID COMMONWEALTH OF PENNSYLVANIA pEPAATMENT OF REVENUE BUREAU OF INDI VIpUAL TAXES DEPT. 280601 HARRISBURG, PA 1 ]126-0601 RECEIVED FROM: BROWN SANDRA L PO BOX 47 DAUPHIN, PA 17018 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXIT t-961 NO. CD 016016 ACN ASSESSMENT AMOUNT CONTROL NUMBER mw ESTATE INFORMATION: ssN: tes-to-assa FILE NUMBER: 2112-0592 DECEDENT NAME: KNAUB ETHEL L DATE OF PAYMENT: 05/24/2012 POSTMARK DATE: 05/16/2012 couNTV: CUMBERLAND DATE OF DEATH: 03/08/2012 REMARKS: SEAL CHECK#1921 12129468 ~ 517.17 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: 517.17 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS t^~ ;+ e~ ~;~ ~: ~{ ,~ a d ~. ~..,. ~`-- ~.,. `~..1 ~ ~~ ~~ b ~-; , n ~ ~ ~ '~ o u- ~ ,_ 6 ' ~ -.y P O ~ r .~ I~wc . -= ,• 0 .n t3 61 N ..+ C'"