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Home My WebLink About07-09-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 77128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-7162 EX(11-961 NO. CD 016227 KRAUSSE ROBERT W 107 W COOVER STREET MECHANICSBURG, PA 17055 -- fold ESTATE INFORMATION: ssN: 307-32-4553 FILE NUMBER: 2112-0124 DECEDENT NAME: KRAUSSE JEWELL M DATE OF PAYMENT: 07/09/201 2 POSTMARK DATE: 07/09/201 2 CouNTY: CUMBERLAND DATE OF DEATH: 01 / 1 7/201 2 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 12108739 ~ 5456.73 TOTAL AMOUNT PAID: 5456.73 CHECK# 8619 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ~~ ~ INFORMA AND NOTICE FILE N0. 21 -~.,1 -I~•, Po Box 280601 +n~p. ACN 12108739 HARRISBURG PA 17128-0601 a ~ Vi o ~ ~Ex nu~~ a TAXPAYER RESPONSE ~.~'~,~~ ~„k~~~,~ DATE 02-06-2012 ~II12 JUl -9 P~9 {2~ 37 ~~yyQ~~F~~~~p't~~-^ipp/~~~iv~~'~S{~tt~nLOi1R rp~ VlJ1Y~C7Cfl1.,!'YVIJ C~., PA KENNETH R KRAUSSE 107 W COOVER ST MECHANICSBURG PA 17055-6434 EST. OF JEWELL KRAUSSE SSN 307-32-4553 DATE OF DEATH 01-17-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING O TRUST CERTIF. MEMBER S 1ST FCU provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this 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 department 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 and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account no. 15YtSt3-41 Date 04-1 Established 1-1974 To ensure proper credit to the account, two copies of this notice must accompany Account Balance Percent Taxable $ X 10, 149.57 100.00 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Amount Subject to Tax ~` 10, 149 .57 NOTE: If tax payments are made within three months of the decedent's date of death Tax Rate X . 045 , deduct a 5 percent discount on the tax due. Potential Tax Due $ 456 .73 Any inheritance tax due will become delinquent nine months after the date of death. P~T 1 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESUL T IN AN OFF ICIAL TAX ASSESSMENT A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or return this notice to the Register of Wills and 0 N E ~ an official assessment will be issued by the PA Department of Revenue. B L 0 C K 0 N L Y g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return fil ed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid Complete PART ~ and/or PART ~ below. . PART It indicating a different tax rate, please state relationship to decedent: 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 Subject to Tax 4 +~ 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due g PAD OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE 1 2 3 _ 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOl1NT aern ~~ L111C ~ yr iax computauonl 8 Under penalties of perjury, I declare that the facts I reported above are true~,7 correct and ~complet to the best of my knowledge and belief. HOME C~~, ~ / Q~~ g~(i/p~ '`~"~`'~ 2~ WORK (7/7 ~ C~ ~ Cj -' TAXPAY SIGNATURE TELEPHONE NUMBER DATE ,~ ~.:.~ ,~.. ~,; _ ~ ,~, ~,: %r' ~': '.[M. fl'; ~'. ~<}) ~~ ` i "'S 3 Q ~~ v ~~ ~ F ~ ``~ ~ ~3~''') ~'~£ ~ZI ~=d 6- ~fl('tfOZ ~ ~~ ~ ~ ~ \ t tr~ :~, ~; ;.,:, ~_ ;:..; ~::~ l