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Home My WebLink About07-09-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 016231 EITLER DOUGLAS 319 EQUUS DRIVE CAMP HILL, PA 1701 1 ---- fold ESTATE INFORMATION: ssrv: iss-~o-1625 FILE NUMBER: 211 1-0868 DECEDENT NAME: EITLER MARGARET M DATE OF PAYMENT: 07/09/2012 POSTMARK DATE: 07/06/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 05/10/201 1 REMARKS: CHECK# 618 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12137806 ~ 5235.71 TOTAL AMOUNT PAID: INITIALS: HMW 5235.71 SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS \~,~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ~~ „ INFORMATION NOTICE FILE N0. 21 11-0868 ~,~" Cap:- , , ~r--t,"`C AND Po Box zao6ol penn ~11~~ I~ + ~+~~~. ~lt~ 12137806 HARRISBURG~PA 17128-0601 AC N oEP^RTMENT~~~~>'Nuq , ~,t;nf ~~aAXPAYER RESPONSE DATE o6-26-2012 REV-1543 EX AFP (05 11) ~,:~, 3 ~ ,,Iut~. "~ ~°'~ ~~~ 2 I TYPE OF _ ~~``~ t'i~`l~i il v(U'~(~~i`iTp /"WS IIAr ~~ IJV.. ("A EST. OF MARGARET EITLER SSN 186-10-1625 DATE OF DEATH 05-10-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: DOUGLAS P EITLER REGISTER OF WILLS 319 EQUUS DR 1 COURTHOUSE SQUARE CAMP HILL PA 17011-8350 CARLISLE PA 17013 ACCOUNT SAVINGS CHECKING TRUST CERTIF. P SECU 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 y0U 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 I BELOW * SEE RE1/ERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. iS65418 0 1 68-S50 Date 06-12-2009 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 10,476.08 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to TaX ~` 5, 238.04 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X 15 deduct a 5 percent discount on the tax due. Potential Tax Due Any inheritance tax due will become delinquent $ 785 • 71 nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL 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 ~ g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, pease state OFFICIAL USE ONLY ~ AAF relationship to decedent:~~ PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X __ ~ _ _ __ 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g_ $ 2, :~ 8 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AM(1lINT Pern Under penalties of perjury, I declare that the facts I reported above are true, correct and c plete to the best~.f my know d and belief. HOME C j `/,/y',/)! WORK C ) ~,~f~ "j /J g,~,~ YL lit ! K//G• AYER IGNATURE TELEPHONE NUMBER DATE IUINL .rncer on Lane 5 or iax Computation) $ -- ,,,:, ~ _o ~, `;~ -~1m r~ ~: 'C ~ `~ a s ~. °~~ F , ~ ~ s~ (~ ~ ~ ~ ~ ~ y /`~ ~~-. ~ J 4i _, F -~ ~ ~ ~ -... ('~ ;~' ~' d.... s r ~.'. 'w.. ?~t (~i CC M ~~ ~ f.f '%~ -~.~ :hk: ~? ~E ~.. . ~ .k ~ ,!~ :, ~H ~ ~ Y ~I , S Jf ~, ~~'. s.~=} ~~~ i 3' N3A3M(~,5~~~1~j ~~~ ~~~g ~~ ~ i i` r