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HomeMy WebLinkAbout06-11-12 (3)` ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE No. 21 BUREAU OF INDIVIDUAL TAXES ~ l~[C(1[ yta~ AND Po sox zgoeol pQn 1 i rl~lC ,`~R'14 ACN 12133066 HARRISBURG PA Inza-osgl OePgpTMe Rk4~w AXPAYE R RE S P D N S E _jl=',,'V,I LC DATE 05-24-2012 acv-~sa, ex •rr cos-~u 2(~I2 JUH ~ ~ TYPE OF ACCOUNT PH ' ~ ~`~ EST. OF KENYON MCCOY ^ snviwcs SSN 171-12-6166 ® CHECKING ^`~`` n DATE OF DEATH 04-09-2012 ^ TRUST ~RPN,A~I~S COURT COUNTY CUMBERLAND ^ CERTIF. ' ^"•D VIJ., fJ~ REMIT PAYMENT AND FD~RMS TD: EMILY M MILLER REGISTER OF WILLS 236 S WEST ST 1 COURTHOUSE SQUARE CARLISLE PA 17013-3878 CARLISLE PA 17'013 PSECU provided the department with the information below, which was ued in calculating the inheritance tax due. Records intlicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If yoU are the spoUge Of the deceased and any amount other than zero 1s 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 in PART 1 Delow 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-]8]-8327 with Questions. COMPLETE PART 1 BELOW a SEE REVERSE SIDE FOR FILING AND PAYM E:NT INSTRUCTIONS Account No. 8005456051-54 Date 04-11-1989 To ensure uroper credit to the account, two Established conies of this notice musk accono env Davnent to khe Reei st er of Wills. Make check Account Balance y` 1,644.98 Day able to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If kax pavnents are natle within three Amount Subject tp Tax g 822.49 months of the tlecedent's data of death, Tax Rate X . 0 4 5 deduct a 5 De rcent discount on the tax due. Anv inheritance tax due will become delinquent P Otenkial Tax Due $ 37.01 nine months after the date of tleath. PART TAXPAYER RESPONSE 1^ A. ^ The above inf ornation and tax due is correct. Resit Davn ant to the Repi ster of Wills wi kh two copies of this notice to obtain a tli scount or avoid interest, or return this notice to khe Register of Wills antl C HEC K an official assessment will be issuatl by the PA Oepa rtment of Rle venue. ONE BLOC K g, ~ The above asset has been or will be reDOMed and tax paid with khe Pennsylvania inheritance tax return ONL Y tiled by the estake representative. C. ^ The above inf orma eon is incorrect and/or debts and tleductions were paid. Conolete PART ~ antl/or PART ~ below. PART If intlicatin9 a different tax rate, please state 2 relationship to decedent: TAX RETURN - CALCULATION OF TAX ON LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Ampunt Su6]eet to Tax 5. Debts and Detluctions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID PAYEE JOINT/TRUST ACCOUNTS DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION er on Line 5 of Tax Computatl.on7 Under penalkies of perjury, I declare that the facts I repo rtetl above are true, co complete to the be;,t of my knowledge and belief. unMF r .~ 1'! 1 ~/ WORK TELEPHON NUMBE MOUNT PAID Z e i an~~ Z l . 1 e - 219 Narih Iianover Sire Garble, Perunylvania 170 717.243.451 ~i -- f ;~ ~ toll free 1.866.451.451 /~JQ~// Q r~ ~ J~ ~ ./) y ) y ~-y p P,, ~'i` ff~~y fax 717.243.37: ~' 1 1 .7 /V / _ ~ - r./ f'~S ~f.~6 T - __. ,.:° ~ '~r.t LP [ WNNI.IIO((RgrYOth.CC FUNERAL HOME ST CREMASORY, INC. info(whofirrarcofh.cc ~ z-~ -~Aco~ i a ~ ~ 30 6s or May 2, 2012 Emily Miller 236 South WEst Street Carlisle, PA 17013 Statement of Funeral Expenses for: Kenyon McCoy Date of Death: April 9, 2012 Account Id: 16526-093 PACKAGE: Immediate Cremation OPTION 5 -Cremation $ 1,890.00 Sub Total: $ 1,890.00 MERCHANDISE: Register Book $ 25.00 Memorial Folders $ 25.00 Sub Total: $ 50.00 TOTAL FUNERAL HOME CHARGES: $ 1,940.00 CASH ADVANCES: 6 Certified Death Certificates at $ 6.00 each $ 36.00 Newspaper Notice -Sentinel $ 177.00 Newspaper Notice -Johnstown/Short $ 114.75 Coroner's Fee $ 25.00 Sub Total: $ 352.75 Total Funeral Expense: $ 2,292.75 Total Payments Made: $ 2,292.75 Payments Made: Emily M. Miller, POA Check 0882 --------------------------------------------------- Please return this portion with your Remittance. $ Amount Enclosed Kenyon McCoy Service ID#: 18526-093 Apr 30, 2012 2,292.75 Balance: S 0.00 SERVING OUR COMMUNITY SINCE 1907 hY/1i - wOMly~ AW~9Y1 ~ waMMif tellan Rant' ~~~, PA 1101! MARKETS •~° -•oo~st ~~ s ~~ ~2 ~,~ M T~ ©~C-T`/ E QTY. DESCRIPTION PRICE PRICE EXT. :1 gs ~^~• 231870 ' USE lY ~' . a ail. ~~ ~~ a98, b~ UST ER ~~ -~J T ~~ ~~ ~~~ ~~ ¢ -i- Q '"" ~ ~ ;- w.r. - w.~w Mww 9'!0 VllaNwf ~Nlas Re*'- MARKETS ~. M 11011 ~ ilY/1 9M4~N ~,,,: ~ O 11 M ,~}~ E TT ply, DESCRIPTION PRICE PRICE EXT. si ~~ cusno SIOWI7 MER X LRE Coat • ~~~~ 231875 OFFICE USE ONL CUSTOMER 1 I a ~ w O y ~ I - ' ti7 ' ~ U ~ ~, o ~ } ` o ~ 7 ; M ~~ _ N Q ~~ , ~ i~ ~ ~ ~ ~ J G ~ Z 2 off. ~- ~ ~ ` ~. ,,. , . ,: =M=~ s :~ r ~~ i \ q ` I } ~~ ~ l q'{ ~~ t y~ !, _~ .~ Y '\ w .,~ ' ~'4"" ~'~ ~ ~ ~ N ~ u+ _ t ~ i. ~ ~ C ~-"- , , ~~ u «! ,. 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