HomeMy WebLinkAbout06-26-12REV-1162 EX111-961
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT.280601
HARRISBURG, PA 1 7 1 28-0601
;ECEIVED FROM:
5478 Clp~j R ROAD
1
CAMP HILL, PA 17011
________ fold
ESTATE INFORMATION:
FILE NUMBER~~
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
PENNSYLVANIA
INHERITOAF ICIANRECEIPT E TAX
SSN: 209-20-6267
2112-0514
SCHERRER JOSEPH J
06/ 26/ 2012
0612512012
CUMBERLAND
04/ 28/ 2012
NO. CD 016169
ACN
ASCON BOLT
NUMBER
TOTAL AMOUNT PAID:
REMARKS:
AMOUNT
529.84
CHECK# 1032 INITIALS: CJ
CEIVED BY: GLENDA EARNER STRASBAUGH
RE
SEAL REGISTER OF WILLS
REGISTER OF WILLS
B~EpU OF INDIVIDUAL TAKES
PO 80X 2B0601 17128-0601
HARRISBURG PA
_ _
.___ _ NNSYLVANIA INHENO ICEE T
INFORMA AND
PE
PAYER RESPONSE
~nsY .-r- ;~~. i~ , ~~
ITMEMT Ad'~~ T'~ ~. .
REY-1541 EX ~FP ~.~
012~2b pMi1~,~
t~ ~~~~j~
(,~..
BRIAN ~
1478 CLOVER
MP HILL
SCHERRER
RD PA 17011-1101
No.21-la-D~S~'~
FILE
pCN .12134536
06-05-2012
DATE
EST. OF JOSEPH SCHERRER
209-20-6267
SSN a~_28-2oI2
DA'Z'E OF DEATH
COUNTY, CUMBERLAND-
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILl'S
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINES
® CNECKIN6
TRUST
CERTIF.
CA due.
inheritance .tax the
used in calculating the the spoyuse of
which was If you are bntPART west
information below. of this account. be due 2,
itn the pUe line, note no tax may„Spouse"
department w Dint owner/benefic~ery and Mriting to this form and return
provided the ou were a ~ Potential Tin PART 1 belor covY
a
named decedent. attac
f the above- financial institution.
deceased by checking Box ~
PNC BANK NA 1s reflected below on the S
from t e
Records indicate that at the death o t0 the
mount other than zero pAYM~ TNSTR{}OTION
and any our relationship uestions. ppD
deceased de artBN•nt of y incorrect. please othagn written correct °n F I L I N6 account, two
If y information is 787-8327 w credit to the
notify the p please calf 717-~'3E ~~EitSE SIDE`°~'POR accovamr
the
ou believe address. 02-06-1984 To ensure vroPanotice oust Nye check
it to the above 1 ~~Ow- this of Nilis.
~#R,` _ covies ote the Resister A ant".
CflMPtETB Dats vay~ant of Wills, o
i 5140165475 Payable to "Resister
Account No. Established within three
3 r 979.00 sots are aa~
$ 16 , (67 NOTE: If tax P~ date of death.
of the decedent's tax due.
Balance X Months
Acc°u^t 663.18 deduct a 5 varoent discount on t •
Taxable Any inheritance tax due will become delinquent
Percent $ , 045 date of death.
Amount Subiact to Tax nine aonths after the
X 29.84
Tax Rata $ RESP. NSE
Potential Tax Due TAjCPAYER
PA~R~T ,
~ ,' orreet. les of this ngtice to obtain
~ +, due is f two cop Mills and
anon.and tax Resister of
A. above inforb .Register of dills with notiu to the
Resit Pay~ent to the or rgturn~Rba:;. tment of Revacwa•
avoid intgresk.b® issWd by the PA DeD?~' return
a discount or ,
an official assessrent will reported and tax Paid with the Pennsylvania inheritance tax
CHECK
ONE B ^ The above asset has been or will be
r filed by the estate representative.
L BLOCK
The above inforea ion lor1p RTreBt be~awr debts and deductions were Paid.
ONLY
C. ~ and/
Coavlete PART
a different tax rate, Please state
PART If indicatineto decedent:
a relationship JOINT/TRUST ACCOUNTS
TAX RETURN - CALCULATION OF TAX ON
1
LINE 1. Date Established 2 $ _
y. Account Balance - _ __ - _ _._ _ _ --
-_~ - _.
'r 3. ParGGRt -T ax~3A $
y, Amount Subiact to Tax 4
5 Debts and Deductions ~ $
6, Amount 7axabls 7 X
7. Tax Rats B
8. lax Due
DEBTS AND DEDUCTIONS CLAIl4~D
P AR7
DATE PAID PAYEE DESCRIPTION
Ii~.-