HomeMy WebLinkAbout08-27-12 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1]128-0801
RECEIVED FROM:
KOONS MICHELLE C
121 N SAINT JOHNS DRIVE
CAMP HILL, PA 17011
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REMARKS:
SEAL
CHECK#103
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
REV-1162 EX111-961
NO. CD 016428
AMOUNT
84,365.44
INITIALS: HEA
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES AND
PO BOX 280681 pennsylvania
HARRISBURG PA nlze-DSgI ~f!'~P?vfRB"N'Me r TAXPAYER RESPONSE
~ PENNSYLVANIA INHERITANCE T'AX
INFORMATION NOTICE
IYrt ur
!~'~~r2 AUG 27 PM 121 ! 7
D~~HAN~ j v(jl~t~ T
MICHELLE GLAND CO„ PA
121 N SAINT JOHNS DR
CAMP HILL PA 17011-1932
EST. OF MAGDALEN M PFLUGER
SSN 191-12-5281
DATE OF DEATH 06-OS-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
M & T BANK Providetl the department with the information below. which was used in calculating the inheritance tax due.
deceased tlandte yaamount other than ezero ei sa reflected tbelow woo the oPOtenti albeTax~DUeyline,~note ono tax m y be due.h but you must he
notify the deoa rtment of your relati onshiD to the deceased by checking Box C in PART 1 below and wri tl ng "sDOUSe" 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 atltl recs. Please call Ill-787-8327 with Questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 15004214409838 Date 04-05-2006 To ensure prover credit 4o the account, two
copies of this notice Husk acconp any
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
Established
~ 61.269.37
X 50.000
~ 30,634.69
X .045
a. 1.378.56
Dayne nt to the Register of Wills. Make check
payable to "Regi star of Wills. A6enk".
NOTE: It tmt paYnents are Wade within three
nonths of the tlecetlent's date of tleath,
dedutk a 5 pe rcenk tli scount on the tax due.
Arty inheritance tax due will becoae delineuent
nine nonkhs. after the data of tleath.
p, ^ The above information and tax due is correct.
of t
i
his notice to obtain
Renik payment to the Register of Wills with es
kwo cop
the Register of Wills and
t
a tliscou nt or avoid interesk, or return this o
notice
K e ssnent will be issued by the
l PA Depa rtne nt of Revenue.
r CHEC ri s
an officia
I
ONE
ill be repo rte0 and
tax paid with
the Pennsv lvania inheritance tax return
L
BLOCK B. ~ The above asset has been or w
ONLY filed by the estate representative.
C. ~he above inforna eon is incorrect and/or tlebts
l
b
~ antl detluckions were paid.
ow.
e
and/ar PART ~
Complete PART
PART If intlicating a different tax rate, Pleasg state
CB OWAIE/2
relationship to tlecedent:
TAX RETURN - CALCULATION
LINE 1. Date Established
2. Account Balance
3. Parc ant Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
DATE PAID
OF TAX ON JOINT/TRUST ACCOUNTS
1 OIi--OS'-ZOO 6
PAYEE DESCRIPTION
OT AL (Enter on Line 5 or iax
FILE N0. 2t ~a~f0' glO
ACN 12137980
DATE 06-27-2012
on) t
AMOUNT PAID
penalties of per ur '. I declare that the facts I reported above are true, c2orrect~/ga~nd ~f~ 7`_
to t be t y knawletlge antl belief. HOME ( 7 ~~ 1 ~" ~ ~ "~'' ~-
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