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Home My WebLink About07-24-12 (5)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: MARPOE BRYAN K 1416 RITNER HIGHWAY SHIPPENSBURG, PA 17257 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 208-24-0437 FILE NUMBER: 2112-0804 DECEDENT NAME: MARPOE HAROLD A DATE OF PAYMENT: 07/24/2012 POSTMARK DATE: 07/24/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/04/2012 REV-1162 EX111-961 NO. CD 016288 ACN ASSESSMENT AMOUNT CONTROL NUMBER 12139980 ~ 5213.76 TOTAL AMOUNT PAID: REMARKS: CHECK# 150 SEAL INITIALS: CJ RECEIVED BY: 5213.76 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 OEPA~IjBR iDK'~I-~NU ~rr11~S'''-~''3'~~7t'~AE C3'(05-117 REV- PENNSYLVANIA INHERITANCE TAX ~~ ~ INFORMA AND NOTICE FILE N0. 21-+,2-Q~y ACN 12139980 ap~~,~~ TAXPAYER RESPONSE DATE 07-16-2012 ~~,;42 JUL 24 P~ 12~ SEi a(~~r~l~~~J l.ri~L~ti~ (BERLAND CQ., PA BRYAN K MARPOE 1416 RITNER HWY SHIPPENSBURG PA 17257-9774 EST. OF HAROLD A MARPOE SSN 208-24-0437 DATE OF DEATH o7-04-2012 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 F CU 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 5p0U5e 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. 287 992-52 Date 08-03-2009 To ensure proper credit to the account, two Established copies of this notice must accompany 0 0 0 .2 7 payment to the Register of Wills. Make check Account Balance $` 1 0 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $` 5,000.14 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 vercent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 225, O1 nine months after the date of death. P~r TAXPAYER RESPONSE ~ ~A7~c~~UIR ~0 ~~ESPOND WILL Ri`S I ANFFI~CIgL TAX SESS T A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ 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 relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxabl 7. Tax R ax Due OF TAX ON JOINT/TRUST ACCOUNTS PAD X 6 v 7 X 8 OFFICIAL USE ONLY AAF PA DEPARTMENT UE 2 3 4 5 6 7 gr... PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTI AMOUNT PAID ,/ TOTAL CEnter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I reported above are true, 2correct and comp to to the best of my knowledge and belief. HOME C '?~~ ) ~7a- a40s ~- ~Ew. i~~ c ~ ~7 ) c~ S K- 4S~ 3 ~3 SKI Via..., TAXPA R SIGNATURE TELEPHONE NUMBER DATE ssvro-isai~ vsn 1 ~ ^' ~7 `` ~ ~ -.^a~C ~. ~.u S ~:. '~.:~:~, ~Oi2 JUL 24 P~ I~~ 50 (~~V.~J ~~Rr ~ ~ S ~ r ^' `` _ 1 1~ ~ ~ ^ v i ~ A 4 /' ~ ~1 V O `- V/ i / ^`Ii/^ ( \ ~ \ ~ ~~~ Y 1 1 "V 1 'w~ r^ ^~ +~ ~r j~f~j~ S-t 4~ .,..~ t'e ~~