HomeMy WebLinkAbout07-24-12 (2)COMMONWEALTH OE PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 016291
MARPOE BRYAN K
1416 RITNER HWY
SHIPPENSBURG, PA 17257
-------- fold
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
12139979 ~ 5427.52
ESTATE INFORMATION:
FILE NUMBER: 211 2-0804
DECEDENT NAME: MARPOE HAROLD A
DATE OF PAYMENT: 07/24/2012
POSTMARK DATE: 07/23/201 2
couNTY: CUMBERLAND
DATE OF DEATH: 07/04/2012
REMARKS:
CHECK#152
SEAL
TOTAL AMOUNT PAID:
INITIALS: HMW
REV-1162 EX~11-96)
5427.52
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES ~-
PO BOX 260601
HARRISBURG PA lnzs-o6ol pEPAR,.+„ENTOF.~~NGe~ +,.;,~ TAXPAYER RESPONSE
REV-1543 E% AFP (05-11)
FILE N0. 21'':7(' c ~~~
ACN 12139979
DATE 07-16-2012
tJr, ' ~~1~~ (~l~tJ
Ct1~?-5='~LRND GC`s , Fj
BRYAN K MARPOE
1416 RITNER HWY
SHIPPENSBURG PA 17257-9774
EST. OF HAROLD A MARPOE
DATE OF DEATH 07-04-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 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. 287992-47 Date 01-12-2009 To ensure proper credit to the account, two
Established copies of this notice must accompany
20 ~ 000.90 payment to the Register of Wills. Make check
Account Balance $ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax ~` 10, 000.45 months of the decedent's date of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 450.02 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. I~ The above information and tax due is correct.
~C]~ 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.
BLOC 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, please state OFFICIAL USE ONLY
relationship to decedent: ~F
PA DEPARTMENT OF UE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 +~ 4
5. Debts and Deductions r~
6. Amount Taxab 6 $ 6
7. Tax e 7 X 7
8 ax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DES AMOUNT PAID
~/ TOTAL (Enter on Line 5 of Tax Computation) $
Under penalties of perjury, I declare that the facts I reported above are true, correct and
compl a to the best of m knowledge and belief. HOME C ~~ ~ ) 5 ~-' ~~(~ Cj
~~ ~ E - ~ ~ i -1 ) t~ S ~'- `~ ~ ?~ ~ ~ 3 ~a 1 I d--
TAX AY SIGNATURE TELEPHONE NUMBER DATE
~, PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
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