HomeMy WebLinkAbout08-30-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXEB
DEPT. 280fi01
HARRISBURG, PA 1]128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
STIMELING ROY E
600 WOODLAND AVENUE
MT HOLLY SPRINGS, PA 17065
mm
ESTATE INFORMATION: ssN: 172-32-1612
FILE NUMBER: 2112-0907
DECEDENT NAME: STIMELING JOSEPH A
DATE OF PAYMENT: 08/30/2012
POSTMARK DATE: 08/30/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 08/05/2012
REV-1162 EXI11-961
NO. CD 016443
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
12145464 ~ 5283.07
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 2920
INITIALS: HEA
RECEIVED BY:
5283.07
GLENDA FA.RNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 1]128-0601
pennsylvania
OEPNPTMENT DF flEVENUE
GEV-1543 EM ,FP (BS -11)
PENNSYLVANIA INHERITANCE TAX (~,~i~y,.
INFORMATION NOTICE FILE N0. 21 ~~'~ vy
AND ACN 12145464
TAXPAYER RESPONSE DArE D8-17-zolz
ROV E STIMELING
600 WOODLAND AVE
MT HOLLY SPGS PA 17065-1927
EST. OF JOSEPH /\ STIMELING
SSN
DATE OF DEATH 118-05-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQIIARE
CARLISLE PA 17013
MEMBERS 1ST FCU provi tletl the department with the information below, which was used in
Recortls indicate that at the tleath of the above-named Oecetlent, you were a 3oint owner/beneficiary of this accpun
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no
notify the department of your relationship to the deceased by checking Box C in PART 1 below and
If you believe the 7nforma ti on is incorrect, please obtain written correction from the financial institution, att
it to the above adtlress. Please call 717-787-8327 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT I
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
,....,
+v
a
C
C. 7
i ng th her'
ou ar he
be bD
"spouse" in
y to tgA fort
T
CT I OIv,S
Account No. 196980-05 Date 09-19-2000 To ensure orooer c etlit to the fafdcount~~v~
Esteb115hetl conies of this notice oust accpwdanv
Davnent tq the Register of Wills. Make check
due.
the
Account Balance >r 12,580.90 Day ab le tq "Register of Wills. Agent".
Percent Taxable X 50.000
NOTE, If tax Davne nts era made within three
Amount Subject to Tax ~` 29 0 .4 5
6, months of the decetlent's date of death,
Tax Rate X . 0 45 deduct a 5 Dercent tli scount on the tax due.
Aro inheritance tax due will become tlelinquenk
POtenkial Tax Du¢ ~ 283.07 nine months after She date of death.
PART TAXPAYER RESPONSE
1^
Unde penalties of per3ury, I tle<lare that the tacks I reported abpve are true, carte ct and
< eta to a est of knowledge and be lS ef. ~
/~f `J~~"' HOME ( 7 7 ) Yh'o~ 3~ip~y
~~ fiC.Y/~~~-~-_, WORK ( 7 / 7 ) o~oZ((~ `//lC d ~"~ ~~~--
TA'~AVER S GNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax ComputatlloN 6