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Home My WebLink About06-19-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1]128-0601 RECEIVED FROM: KUTCHMAN WILLIAM 3014 DICKINSON AVE CAMP HILL, PA 17011 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-7162 EXIt 1-961 N0. CD 016131 ACN ASSESSMENT AMOUNT CONTROL NUMBER rota ESTATE INFORMATION: Ssty: FILE NUMBER: 2112-0551 DECEDENT NAME: KUTCHMAN SYLVIA M DATE OF PAYMENT: 06/19/2012 POSTMARK DATE: 06/18/2012 COUNTY: CUMBERLAND DATE OF DEATH: 04/30/2012 12135722 ~ 564.77 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 2305 INITIALS: HEA RECEIVED BY: $64.77 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1 ]12R-Ofi01 RECEIVED FROM: KUTCHMAN WILLIAM 3014 DICKINSON AVE CAMP HILL, PA 17011 ---- --- IoIE PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSr1: FILE NUMBER: 2112-0551 DECEDENT NAME: KUTCHMAN SYLVIA M DATE OF PAYMENT: 06/19/2012 POSTMARK DATE: 06/18/2012 COUNTY: CUMBERLAND DATE OF DEATH: 04/30/2012 REV-1162 EX~11-961 NO. CD 016131 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12135722 ~ 564.77 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 2305 INITIALS: HEA RECEIVED BY: 564.77 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER BUREAU OF INDIVIDUAL TAXES PD Box zeocBl HARRISBURG PA 1]128-0601 Pennsylvania OEPNflTMENT DF PE VENUE REY-1543 EM RFP <YS-]I) PENNSYLVANIA INHERITANCE TAX ~~ ~~ INFORMATION NOTICE FILE No. 21 AND ACN 12135722 TAXPAYER RESPONSE DATE o6-12-2012 WILLIAM KUTCHMAN 3014 DICKINSON AVE CAMP HILL PA 17011-5228 EST. OF SYLVIA KU DATE OF DEATH 04-30-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SOVEREIGN BANK prpvitled the department with the information below, whi <h was usetl in calculating the inheritance tax tlue. Records intli ca to that at the tlea th of the abov e-named decetlen t. you were a joint owner/beneficiary of this account. IT y0U are 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 deDa rtment of your relationship to the deceased by checking Box C in PART 1 below and Wri tang "spouse" in PART 2. If ypu 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 REVERSE SIDE FOR FILING AND PAYME'.NT INSTRUCTIONS Account No. 2331028826 Date 05-01-1997 To ensure proper credit to the account, two Establishetl copies of '[his notice must aceonpany pavnent to the Register of Wills. Make check Account Balance $ 863.59 pavable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTES If tax DaymeMS era made wikhin three Amount Subject to Tax $ 431.80 months of the decetlent's tlate of death, Tax Rate )( , 1 5 deduct a 5 percent discount on the tax due. AFn/ in heri Fence taz tlue dill becone delinquent Potential Tax Due Se 64.77 nine nonths after the Gate of tleakh. PART TAXPAYER RESPON SE 1^ A, fJ The above info raa4ion antl tax tlue is correct. LGe Reait pawn ent to the Register of Wills with two copies of t his notice to obtain a tli scouni or avoid interest, or return this notice to the Register of Wills and C HEC K r an official asse ssnent will be issued by the PA Oepa rtnent of R'.e venue. I ONE L BLOCK B. ~ The above assek has bean or will be ra oo rtetl and tax paid with the Pennsylvania inheritance Fax return ~ ONL Y tiletl by the estate representative. ; C. ~ The above inf orna ion is incorrect and/or debts Complete PART ~2 and/or PART ~ below. and tleductions we rep paid. ~~ rV ~ ~ _ . C !?~~+ ~~;. ~ PART If indicating a different tax rate, please state "'il6 f '. ~/ 6 i f ~ ~~ relationship Yo decetlent: h F' ~~ ~ l~~~ 5 P ~ TAX RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS ~ ~~ ~ ` ~ 'W LINE 1. Date EstablSShetl 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 ~ 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 1 reported above/fa rout rue~,t correct and complet e~~D the (be3toj m!y,kno1wledge and belief. HOME • 1 ~ I ) 1 /C~/dy (4^" /'i~Mlfi"""/~/ WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DA pAR7 DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~. , r; {~5 ri ti., fi h r~ {,r~~ zA :%, C'! ~J ~a ".a '~ Vr t~ ~- ~ ~ n '' vJ ~ ~ ~ ~ ~ ~' S _. ~ ~~ ~ ~ L~ ~ Q ,~~ ~ z~ <_ ~.. ~: :: ~, ~ ~ ~~3 ~ _. ~ti ~ I~~~ %: ~ ~ ~ ~J A ~, ~~~ -. off. 3 ~ ~ . , rb 1 ~- vV ~.~ ~~i ~Y {:M {T~ .~.~ ~.~ ...~