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Home My WebLink About09-25-12-~ PENNSYLVANIA INHERITANCE TAX ~'~ BUREAU OF INDIVIDUAL TAXES ~ r ~. F~,_- INFORMATION NOTICE ../~, /~J - w~ nn F I L E N 0. 21 ~''_/ ~~' Po Box 2BO6o1 enns ~Vd ~~~-~~~~' ` ;~'`'1~~. V~ AND HARRISBURG PA 17128-0601 ~ + ~ ;~ _-•---:~. -~ ACN 12132051 DEPARTMENT OF REVENU~ ~~ •, f}-t F '~~.~~ Y E R R E S P O N S E o 5- 18 - 2 012 REV-1543 EX AFP (OS-111 '~.ll~,, ,, _ y" _~,Aj DATE K?~~ ~~P ~~ ~~ i~: ~ ~ TYPE OF ACCOUNT EST. OF HAROLD MUSSELMAN ~ SAVINGS S$N 188-32-2776 ~ CHECKING ~Q[)``,. ~ DATE OF DEATH 05 - O 1 - 2012 ~ TRUST Vi lI~`f i"il~~I~~ Vi.it~i~i~ ~~~~~~~-~D CQ., PA COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: AMANDA MUSSELMAN REGISTER OF WILLS 235 CLAY RD 1 COURTHOUSE SQUARE CARLISLE PA 17015-9468 CARLISLE PA 17013 MEMBER S 1S T F C U 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 he 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. 206539-00 Date 06-25-2001 To ensure proper credit to the account, two Established copies of this notice must accompany 5 9 5 . $ $ payment to the Register of Wills. Make check Account Balance $ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 99.32 months of the decedent's date of death, Tax Rate )( . 045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 4 • 47 nine months after the date of death. P~T TAXPAYER RESPONSE 1 FAILURE TO RESPOND WILL 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 BLOC 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 information 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 OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT. OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~~7/(Z L-L r+' f-LtnC<~C( -~~r'Yl~y ~.'1 C.~~:~ 'L } 2.'1~ts 1 ,3 J~ IUIHL 1G11Ler on pine 5 or iax computation) $ Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief . HOME C `1 17 ) 3 3~ " (~~ 7 ~ n _ i7 SIGNATURE WORK ( ) q/2yl~Z DATE TELEPHONE NUMBER ~~, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE /~ ~~~~ BUREAU OF INDIVIDUAL TAXES r (~!'~. 1r~ s''"~" ~ t" FILE NO. 21"' PD Box 2so6o1 i~ ~.: ~.~ "~t~~ ~a AND HARRISBURG PA 17128-0601 pennsyl ~; .__ ;~j ACN 12132053 DEPARTMENT OF REV ~-~ ,~~ ~ ~ ;`~;IA~~AYER RESPONSE DATE 05-18-2012 REY-1543 E7( AFP (OS-11) ~~~5~~25 t~-~II' ~I ..- i.. _. ~~..,, . Qi~PN~-,~~ ~ ~~~n ~ AMANDA MUSSELMAN 235 CLAY RD CARLISLE PA 17015-9468 EST. OF HAROLD MUSSELMAN SSN 188-32-2776 DATE OF DEATH 05-01-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1S T F C U 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 y OU 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 he 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. 206539-11 Date 01-05-2010 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 739.46 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16 . b67 NOTE: If tax payments are made within three Amount Subject to Tax ~` 123.25 months of the decedent's date of death, Tax Rate )( . 045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential T8x Due $ 5.55 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILURE TO RESPOND WILL RESULTINAN 17fFICIAL 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 BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return O N L Y filed by the estate representative. C. ~ The above information 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 UFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X __ ~ 4. Amount Subject to Tax 4 $ f~ 5. Debts and Deductions 5 Cj 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ g PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ -~: t; F~i.~nc,c.( ~.n~ ccnc-~:l ~~~t.,srs `~ 3e'c~.... IUIHL ~tnLer on pine 5 or iax computation) S Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of ~y knowledge and belief . HOME C 7 ~ ? ) ~j ~G - d?~ ~ 2.. WORK C ) ER SI A URE TELEPHONE NUMBER DATE 15 Big Spring Avenue NEWVILLE, PENNSYLVANIA 17241 F. CHARLES EGGER, Supervisor 717-776-3414 FRANK C. EGGER, Funeral Director May 17, 2012 Funeral bill for Harold R. Musselman Date of service May 4,2012 Professional Services $3,510.00 10 Death Certificates $6.00 a piece $60.00 Clergy offering $100.00 Burial Vault $990.00 White Majestic 20 gauge casket $1,875..00 Cemetery Opening $845.00 Total $7,380.00 -..~_ ~ ~ ~ ~:~ ~ r ~" 't7 ~' ' " : 27 ~} % ~ ~'. , , ~.~J µ t ~ n~.-~%- A ? ~ -~-~ ~~ 7 i .. .. _ - `~ O '~ ..... "i'1 mod. - r, ~,s J~c r~ , ~;, (~ ,., ~ r 'b~ fr:.} „'.,~ .>i ~, . y 3. ,i,,; JS. ~}~,f fir': _. ' M¢u ~ .<fi r:, x ;, ~ ,.~ C ~ _ , ~ ~ _ ' ~" ,i ~~..~ ~~ : ~ _.- _ - ~r ~ , ~Y ~ .:, /3 ~, ~ `~ \. ,.1 - J ~ ~ _~ n :~ f, ~ ~, ~, .~ ~- ~ _~ r~.r t.' ,t.., i "~ 4'.. ..i