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Home My WebLink About06-07-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1]128-0601 RECEIVED FROM: PEARCEJOHN W 617E 73RD ST KANSAS CITY, MO 64131 rom ESTATE INFORMATION: ssN: aoz-la-loal FILE NUMBER: 2112-0642 DECEDENT NAME: PEARCE CATHRYN DATE OF PAYMENT: 06/11/2012 POSTMARK DATE: 06/07/2012 COUNTY: CUMBERLAND DATE OF DEATH: 02/ 1 8/201 2 REV-1162 EX111-961 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 016085 AMOUNT ACN ASSESSMENT CONTROL NUMBER 12118620 ~ 520.11 12118622 ~ 53.19 523.30 TOTAL AMOUNT PAID: REMARKS: CHECK# 2308 SEAL INITIALS: HEA RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 1]128-0601 REV-1543 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE ND. 21 ~~~~~~ AND ACN 12118620 1_M ~XPAYER RESPONSE DATE 03-16-2012 u, :gym i c 2012 JUN -7 PM 21 I 0 '..L!` it 'j ~BERlq jD C~'0., Pq JOHN PEARCE 617 E 73RD ST KANSAS CITY MO 64131-1624 EST. OF CATHRYN PEARCE SSN 302-14-1041 DATE OF DEATH 02-18-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FfIR MS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA li'013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provitle0 the tlepartment with the information below, which was used in calculating the inheritance tax tlue. Recortls intlicate that at the death of the above -nametl tlecedent, you were a 7of nt owner/beneficiary of this account. If you ere 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 deua rtment 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 antl return it to the above address. Please call 717-787-8327 with Hues ti on s. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 205129-0 0 Date 08-06-2081 To ensure Drooer credit to the account, two Established cosies of this notice Host acconoanY pavnant to the Register of Wills. Make check Account Balance ~` 2.680.95 Datable tD "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax Daynents are natle within three Amount Subject to Tax $ 446.83 months of the decedent's date of death, Tax Rate X , 045 deduct a 5 D¢rcent tli scount on the tax due. Aro inheritance tax tlue will b¢eone delinauant Potential THX Due ~ 28.11 nine months after Sha date of death. PART TAXPAYER RESPONSE 1^ A. IAA The above information antl tax due is correct. W Remit oaYnent to the Register of Wills with two conies of this notice ko obtain a tliscou n4 or avoid interest, or return this notice !o the Register of Wills and r CHECK an official assessment will be issuetl by the PA DeDartnent of lievenue. I ONE ~ L BLOC K B. ~ The above asset has been or will be reoo rtetl and tax Daid with the Pennsylvania inheritance !ax return ONL Y filetl by the estate reorasantative. L. ~ The above inforna ion is incorrect and/or debts and deductions wer~a Daid. Loaglete PART ~ and/or PART ~ below. p AR7 If intlicating a tlifferent tax rate, please relationship to decetlent: TAX RETURN - CALCULATION LINE 1. Data Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax S. Debts and Detluctions 6. Amount Taxable 7. Tax Rake 8. Tax Due PART DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS DESCRIPTION AMOUNT PAID Under penalties of perjury, I tleelare thak the facts I reported above pa re true22nn~or~ex<,~t and <omple to' 1t he t of my knowledge and belief. HOME IFS~lP ) .JI/5 V107 /~'~,,. W ~ ~•Q4an-C~~- WORK ( ) ra a co cT r_uATIICF TELEPHONE NUMBER DATE BUREAU OF INDIYIDUAL TAXES PD BOX 280601 P~~m~/t HARRISBURG PA 17128-Bf BI DEVAXTMENT dF'REVEAU PEV-1543 EX .4FP <YS-I1 ~ PENNSYLVANIA INHERITANCE TAX ~C i~r~ ~ ~ INFORMATION NOTICE FILE No. 21 AND ACN 12118622 $,Il1S TAXPAYER RESPONSE DATE 03-16-2012 !~UI9 =T PM 2~ ! ',a_C:~n ~ Opl~~p~H~A~N~'~S~I~C(O~JR rpA Wm~Clll,ry YlJ VV.. f•/S JOHN PEARCE 617 E 73RD ST KANSAS CITY MO 64131-1624 EST. OF CATHRYN PEARCE SSN 302-14-1041 DATE OF DEATH 02-18-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FCIRMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17'013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FLU provitletl the department with the information below, uhi ch was usetl in calculating the inheritance tax due. Recortls indicate that at the death of the above-nametl decedent. you were a joint owner/beneficiary of this account. If y0U ere the BDOUSe Of the deceased and any amount other than zero is reflected below on the Potential Tax Due itne, 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" 1n PART 2. If you believe the information is incorrect. please obtain written correction from the financial institution, attach a copy to this farm antl return it to the above adtlress. Please call 717-787-8327 with euesti ons. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 208129-11 Date 08-06-2001 To ensure groper credit to the account, two Established copies of This notice nu st accomganv Daynent to the Register of Wills. Make check Account Balen<a $ 425.00 oavable to ''Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If Yax paYnents are matle within three Amount Subj act to Tax $ 70.83 nonths of the decedent's tlate of death, t X , D 4 5 deduct a 5 percent discount on the tax due. Tax Ra e AnY inheritance Yax due will become tlelinauent PatenYial Tax Due $ 3.19 nine months after The date of death. PART TAXPAYER RESPONSE A. The above information and Tax due is co rreck. ~ Renit payment to the Register of Wills with two copies of Yhis notice to obtain a discount or avoitl interest, or return this notice ko the Rae inter of Wills antl r CHEC K an official assessment will be issuetl by the PA Departnent of Revenue. ONE ~ L BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pen nsYlvania inhe rikance tax reku rn ONL Y tiled by the estate representative. C. ~ The above info rna ton is incorrect and/or debts and detlu ctions were said. Congleke PART ~2 and/or PART ~ below. PART If indicating a different tax rate, please stale relationship to tleeedent: 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 Subiect to Tax 4 $ 5. Debts antl Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X e. Tax Dua 8 $ PART DEBTS AND DEDUCTIONS CLAIMED Untler penalties of pa rjury, I declare that The facts I reported above ~~a//r//e~~Yruep, cor~r4~QQ~t and compl e~t~best of my knowledge antl belief. HOME CQIlO 1 3o s V (~ 7 ~~,(R/ WORK ( ) ~vm wro crr_uw Tlloc TFI FPHONE NDMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID -i 7 i '. S -; 5 ' ' ( s) P~ ~ i ~, x yyy ~ '6 1 {{f ~ 1 M1 ~ C~-. ~~ C" ~,. i ~ "'~ IJ " / n/ Q ~ (` i1 ~~ ~ Q ~ `. q V z ~ ~ ~ v 4 ~c-`~ P'-n C_ C Z J Z ,~ Q ~~~~X ~~ ~7' r- ... __ n L7 u t7 ~.~ i.:J .»