Loading...
HomeMy WebLinkAbout08-20-12REV-1162EXI11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: SCHAD DENNIS J 310 SHATTO DRIVE CARLISLE, PA 17013 +a~a PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssrv: 5o~-is-95x3 FILE NUMBER: 2112-0813 DECEDENT NAME: SCHAD HELEN A DATE OF PAYMENT: 08/ 20/ 201 2 POSTMARK DATE: 08/20/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/ 1 1 /201 2 ACN ASSESSMENT CONTROL NUMBER AMOUNT 12143552 ~ 525.10 TOTAL AMOUNT PAID: REMARKS: CHECK# 200 SEAL INITIALS: CJ RECEIVED BY: 525.10 GLENDA EARNER STRASBAUGH REGISTER OF WILLS NO. CD 016408 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 penn . ~. DEPARTMENT dl''RE4El~ktlEr- REV-1543 E%' AFP ~('I PENNSYLVANIA INHERITANCE TAX c INFORMATION NOTICE FILE N0. 21 ~~2'C~p ~~ ~~-~~_ AND ACN 12143552 }n~~... !. TAXPAYER RESPONSE DATE 08-03-2012 V! ~1 ?''~``J 20 P~ ~ EST. OF HELEN A SHAD SSN 507-16-9593 l,~,C.j ~ ~ s',~~ DATE OF DEATH 0 7 -11- 2 012 ('~ ~a "~'~~~5 C~ ~ ~ COUNTY CUMBERLAND CU~IBER(,gNp Gf / ~ REMIT PAYMENT AND FORMS T0: DENNIS J SCHAD REGISTER OF WILLS 310 SHATTO DR 1 COURTHOUSE SQUARE CARLISLE PA 17013-2139 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1 ST 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 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. 313945-11 Date 09-1 5-2007 To ensure proper credit to the account, two Establ ished copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 1 ~ 115 • 37 payable to "Register of Wills, Agent". Percent Taxable X 50 .000 NOTE: If t"ax payments are made within three Amount Subject t0 Tax ~` 557 .69 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 del inquent Potential Tax Due ~` 25 • 10 nine months after the date of death. PART TAXPAYER RESPONSE 1^ FAILURE TO RESP,.OND WILL RESIT IN AN~OFFI CIAL 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 a discount or avoid interest, or return this notice to the Register of Wills and C H E C K 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 Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 '~ 7 X 8 $ OFFICIAL USE Oh1LX~~~~~ qAF PA DEPARTMENT OF REVENUE PAD 1 2 3 4 5 ~~~ 6 7 ~\ 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pe al ies of perjury, comple to the best of my d c are that the facts I no and ief. reported above are HOME C'~~ WORK ( true, cor~Jec and ) Z ) ~~~~ %~ /Z AXPAYER SIGNATURE TELEPHONE NUMBER D TE _ TOTAL CEnter on Line 5 of Tax Computation) S B~`~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES INFORMATION NOTICE FILE N0. 21-~~_ ©D~~ Po Box zaocol ± HARRISBURG PA ~~ ~ 6~' ~ ,.~ j~j~Qylvania !~ ~ AND ACN 12143552 J'~ ` V ~ ~ ro 9NTOFREVENUE TAXPAYER RESPONSE ~^( + y { ~ ~.r (_.*( ~~ (uL'~yy / _~ ~~, f;trFR Pfi63 EX AFP (OS-11) DATE os-o3-2012 ~~~i~2 (BUG 20 P~ 2~ 35 DENNIS~ ~RJ 'SCHAD" PA 310 SHATTO DR CARLISLE PA 17013-2139 EST. OF HELEN A SHAD SSN 507-16-9593 DATE OF DEATH o7-11-2012 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 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 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 313945-1 1 Date 09-15-2007 To ensure proper credit to the account, two Established copies of this notice must accompany 1 1 5. 3 7 payment to the Register of Wills. Make check Account Balance ~` 1 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 557.69 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any inheritance tax duewill become delinquent Potential Tax Due $ 25.10 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WALL 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 an official assessment will be issued by the PA Department of Revenue. 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 3^ below. PART If indicating a different tax rate, please state relationship to decedent: ~~~~ TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 1 1 2 $ 2 a X 3 4 $ 4 5 5 6 $ 6 ~ X 7 8 '~ g OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE oooo PART DEBTS AND DEDUCTIONS CLAIMED 3^ . DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under en lties of perju y, declare that the facts I reported above are/ true,//c//orreJJct and compl e o the beFt of w edge nd belief. HOME C~L~) 5~~1i" ~~~~ WORK C ) TAXPAYER SIGNATUR TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) $ i ~ ~~ ~ f~. _a ^,- '~. };~1: ~Ee ~, ~ti ~!y - E.y' ,~. ~,i ' ..~ ~. ~ ~~-; ::~ ~° I~ vsr t'~'~2 AUG 2p PM Z: ~~ ;: . ~~~ ~~ v~'Jh ~ vo ca., ~ ~~~ O „~ J yv J `~ ~J _ ,. \ _ M .ti O r ~ p ti o Cw ~^ a. Q 3i ~ n ri O '+ M U ~~ ~~ J V \` ~~, cr; ~~ ;r~ {g~ f~i i ~f .,.~