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Home My WebLink About05-29-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 71 28-060 7 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WILLIAMS GREGORY 122 CAMBRIDGE DR MECHANICSBURG, PA 17055 told FILE NUMBER: 2112-0531 DECEDENT NAME: WILLIAMS DONNA B DATE OF PAYMENT: 05/29/2012 POSTMARK DATE: 05/04/201 2 couNTY: CUMBERLAND DATE OF DEATH: 03/12/2012 REV-1162 EX(11-96) NO. CD 016024 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12128705 ~ 533.17 TOTAL AMOUNT PAID: REMARKS: CHECK# 617 SEAL INITIALS: HMW 533.17 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH 0~~.°+~aS~T?VANIA REV-1162 EX(11-96) ~[PARTM~NT OF REVENUE BUREAU OF INDIVIDUAL TARES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015943 SHORT WILLIAM M 71 SMITH RD NEWVILLE, PA 17241 fold ESTATE INFORMATION: ssN: ohs-i 6-szz2 FILE NUMBER: 2112-$5.3x2' ~~~ 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 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12128705 ~ 533.17 TOTAL AMOUNT PAID: 533.17 REMARKS: CHECK# 617 ~~~%~~~ INITIALS: HMW SEAL ~V~~,or'~'. RECEIVED BY: GLENDA EARNER STRASBAUGH ,~~ '~~~GISTER.~`~ F WILLS -~ r. tl~~t'E~ LP.;~J•i~rl ~l~.~ t°~L~Cf~r~- /7L~Jd? ~ f 4K s'-' I~~6~r ~~, '` ~~ ~ f,-r'/'. ~ j% r!'1 Cis :~v~ G~ t_ ~ ~ ,fin ~~~~d rn l~<<~~~ ~s~~~t~. r~~~ d-~-r REGISTER OF WILLS / ~ ~ ~ ~, PENNSYLVANIA INHERITANCE TAX _ auREAU DE INDIVIDUAL'.".X ES ~ , ~., ,._,+~~. INFORMATION NOTICE FILE N0. 21 ~~'S ~, I PO sox 260601 Pen ~ ~~~ ~ i~~r ~j AND ACN 121 8705 HARRISBURG PA 17128-0601 pEPARTME oF:~~yENi,E - i C' TAX P AY E R R E S P O N S E ~. .,.,~ DATE 04-30-2012 FEV-1543 E% FFP (OS -11) .. 't s{r ~i1 1' L} I CLERK r; ~~~~,~~~~'~ ;C~~R~ CU~,,~~,~~i ,;,;,~.~ CC; r~A TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 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 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 you art 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 REYEIZSE SIDE FOR FILING AN17 F'AIIMENT INSTRUCTIONS Account No. 21001016280 Date 01-28-1988 To ensure proper credit to the account, two Establ ished copies of this notice must accompany payment to the Register of Wills. Make check Account Balance 4 656.00 r payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax ti{` 776.02 XNDTE: If tax PaylpE q_ is are made within thre months of a decedeo~t''s„date of death, ? ~ Tax Rate X . 045 deduct a 5 percent disco nt on the tax due. ~~a Any inhe a will become delinquent Potential Tax Due $ 34.92 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPDND WILL RESULT IN AN OFF ICIAL TAX ASSESSMENT A. M The above information and tax due is correct. I~ 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 O N E an official assessment 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 information 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 OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE I. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 - -- ~.- .,.~-.--_ 4. Amount Subject to Tax 4 $ f+ 5. Debts and Deductions 5 - ~j 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 c mplete to the best of my kn wledge and belief. HOME C~~ ~ ) ~~~' ~ ~1 T ~ ' [ V ,, ll ~< W WORK C -]~' ) ~c3~I' Y, f( ~`i `l ~ -.~ "'' 2 TAXPAYE SI NATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) 5