The URL can be used to link to this page

Home My WebLink About06-07-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%E8 DEPT. 280601 HARRISBURG, PA 1 ]128-0601 RECEIVED FROM: COULSON DELORES J 616 HIGHLAND AVE CARLISLE, PA 17013 mle PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: 173-of-55a~ FILE NUMBER: 2112-0393 DECEDENT NAME: COULSON GEORGETTA J DATE OF PAYMENT: 06/07/2012 POSTMARK DATE: 06/06/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 03/19/2012 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX111-961 NO. CD 016073 AMOUNT 12122515 ~ 5135.92 12122516 ~ 5135.93 TOTAL AMOUNT PAID: REMARKS: 5271.85 CHECK# 7738 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 12-0393 BUREAU OF INDIVIDUAL TAXES Po BOX 280601 P ~ ~~~' -•,~ AND ACN 12122515 HARRISBURG PA 17128-0601 YpAY~D oerA bk'~Bkxp .'~t~'!4~ * ~A"R E~1I SF'D f~~IS~~N$~ * w DATE 04-20-2012 XEV -]56] E,tJJ,.FP [~IlS -1~ 2Q12 Jl1N -7 PM 1155 ORPHAN'S t~OURj CUM~RLAND CO., PA DELORES COULSON 616 HIGHLAND AVE CARLISLE PA 17013-4107 EST. OF GEORGET'iA J COULSON SSN 173-01-5587 DATE OF DEATH D3-19-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TO: REGISTER OF WILILS 1 COURTHOUSE S4UARE CARLISLE PA 11013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the department with the information below. which was usetl in calculating the inheritance tax due. Records intli cate {hat at the tlea th of the above-named decedent, you were~a joint owner/beneficiary of thi ;; account. If you 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 depDartment of your relationship to the tleceasetl by checking Box C in PART 1 below antl writing "spouse" in PART 2. If you believe th9 information is incorrect, please obtain written correction from the Financial ins ti tut'on, attach a coDY to this form and return tt to the above address. Please c.i4a,ij?-.787-8327 with cues ti ons. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE: FOR FILING AND PAYMENT INSTRUCTIONS Account Ho. 157273-00 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 03-08-1996 Established $ 2,836.16 X 50.000 $ 1,418.08 X '.045 $ 6 .81 To ensure proper credit to the account, two copies of this notice must acconDanv Dayaent to the Reei star of Wills. Make check payable fa "Repisker of Will s, Agent^. NOTE: If tax payments are natle within three months of the tlec ed ant's tlate of death. tleduct a 5 De rcant discount on the tax due. Any inherit ante tax tlua will become delinmuent nine nonthis after the tlate of tleath. P T TAXPAYER RESPON SE ~ 1 A. ^ The above inf ornation and tax tlua is correct. Resit pays ant to the Reei stet of Wills with two copies of This notice to obtain CHECK a tli seount or avoid interest, or return this notice to the RaB:ister of Wills antl en official assessment will be i ssuetl by the PA Oepa rtnenY of Revenue. C ONE ~ BLOCK B. ~ The above asset has been or will be reDOrtetl and tax Paid with the Pennsylvania inheritance tax return ONL Y filatl by the estate representative." C. ® The above inf orna eon is inrorrect ntl/or tlebts and deductions were paitl. Conolete PART ~ antl/or PART ~ b elow. PART If indicating a tlifferent rate, ea a st e relationship to tloeetlent: 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/TR 7 Untler penalties of perjury, I declare that the fasts I reported above ~ajre true,~rr.e ct'anq ~Q po ate o the bas o my k wledge//and belief. HOME C(~~) ~7L9 CrS/ ~~~ ~l~Il~f'/.1./~Iif WORK C ) I ~ - ~ ^~~ PAYER $IGNATUR TELEPHONE NUMBER DATE PART DEBTS AND+. DEDUCTIONS CLAIMED DATE PAID PAYEE ~ DESCRIPTION t AMOUNT PAID ~ PENNSTTYNL~VANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES COP~EG~"~~ ~/A~~TION NOTICE FILE N0. 21 12-0393 PD BOX 280607 pennsylvani ~eJ(~f(-~I~C. 11 i ~/IAND ACN 12122516 HARRISBURG PA 1]128-0601 pEFAximexT OF Revexue REGic T._ A~,IfeJ'~' ~ ~E)S~~~I'IS~ ~~"z~ u * • DATE 04-20-2012 REV-1563 E% RFr f05 -I1) C 1011 JUM -7 PM ~: 59 TYPE OF ACCOUNT EST. OF GEORGETTA J COULSON ® saviNGs . .r SSN 173-01-5587 ^cNEDZiNG l-L~_~i, ~~~~5 vI~URT DATE OF DEATN 03-19-2012 ^ rausT ~~~~D ~R ~aCOUNTY CUMBERLAND p/'T ^ CERTIF. EMIT PAYMENT AND FORMS T0: ~ / 3 DELORES COULSON REGISTER OF WILLS 11 ~1 616 HIGHLAND AVE 1 COURTHOUSE SQUARE V~ CARLISLE PA 17013-4107 CARLISLE PA 17013 MEMBERS 1ST FCU provitled the department with the information below. which was used in calculating the inheritance tax due. Records intli cote that at the death of the above-named decedent. you were a joint owner/beneficiary of this a¢ount. If you are the Spouse of the deceased and any amount other than zero is reflected below On the Potential Taz Bue line, note no tax may be due, but you must notify the de artment of your relationship to the deceased by checking Box C to 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 atltlress. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW ~`S EE ~R EVERSE SIDE FOR FILING AND PAYMENT INSTRUC TIDNS A<count No. 157273-05 A<count Halan<e Per<ent Taxable Amount Subject to Tax Tax Rata Potential Tax Due PART Date 03-OS-1996 Established $ 16,049.32 X 50.000 $ 8,024.66 X .045 361.11 To ensure proper credit to the account, two copies of this notice Husk acconpanY pavnent to the Re9ist er of Wills. Make check vavable to "Rapt star of Wills. Agent". NOTE: If tax vavnents are made within three •onths of the tlecedank's date of death, deduct a 5~ pe rcenY tli sc oust on the tax tlue. Arty inheritance taz tlue will becone tlelinauent nine months of ker the date of tleath. A. ^ Tha above info rnation and tax due is correct. Resit paynenY fo the Re pi star of Wills with two copies of this notice to obtain CHECK a tliscount or avoid interest, or return this notice ko the Rep:ister of Wills and ONE ~ an official assessment will be issued by the PA Devarinank of Revenue. BLOCK B. ^ The above asset has been or will be reported and tax void with the Pennsylvania inheritance tax return ONL Y filed by the estate rev resankative. C. ~ The above inf or__n~~a~~tyeon is incorrect antl/or debts antl deductions were void. Complete PART ~ antl/or PART ~ below. PART If indicating a different fix rate, ease state ~~l relationship to decedent: `.~t~J'~ ~1~/N~ ~ w TAX RETURN - CALCULATION OF ,TdAX ON JO NT/TRUST ACCOUNTS LINE 1. Date Established 1 ,% - o - /99~ 2. Account Balance z ~/~, b ~9. _3~ e 3. Percent Taxahla i ~-_ ^ 6 4. Amount Subject to Tax 4 $ d lv 5. Debts antl Deductions 5 - .~,.~~Jj~.~. ~~~ 6. Amount Taxable 6 $ ~ 9 ~~•~ ?J 7. Tax Rate 7 X .~a v B~5 ~'r 8. Tax Oue 8 S ~S.L~cK. -~-ri PART DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID - / e 3, - nd ' I /. a r/ ~uiAl ttnter on use s ot'Tax Compu t'a tioN e.,"~j Of53.5-~ Untlar penalties of perjury, I tle<lare that the facts I reported above are true, cqo rre cGt an~tl'/ // c/of/'plat to the b t of my knowledge antl belief. HOME C y~7 ) /J/ ~/.- jj T~ ~YiB I'~O ~ ~ /~_ /7il WORK ( ) _ TTTT AYER SIGNA RE TELEPHONE NUMBER DAT~ ,. ~~ ~ ~~ ~\ ~ ~ ~~ ~~~ :~ ~~ ~~ ~~ ~ ~~ ~j ~ ~ S ~ Z` r; , "al ,::~?I"!j i 7 ~'~ ~ ``~~ N I Y" ~ :: C `'~ ~i . . ffi ~~ p~~} f~ ~. ~ "t] rr ~R ~.4 ~~~ ~ Yx