HomeMy WebLinkAbout10-02-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 016577
MEMINGER JUDY CARHART
466 ARLINGTON RD
CAMP HILL, PA 1 701 1-21 06
fold
REMARKS:
CHECK# 4058
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
INITIALS: DMB
RECEIVED BY:
REGISTER OF WILLS
REGISTER OF WILLS
5224.18
GLENDA EARNER STRASBAUGH
~ •
~~ PENNSYLVANIA INHERITANCE T
BUREAU OF INDIVIDUAL raxES ~ INFORMATION NOTICE
Po Box zao6ol Pennsylvania AND
HARRISBURG PA 17128-0601
DEPARTMENT OF REVENUE TAXPAYER RESPONSE
REV-1543 E% nFP (RS-11)
FILE N0. 21 'IZ' ~U7~
ACN 12145558
DATE 08-17-2012
EST. OF MARY J CARHART
SSN
DATE OF DEATH 07-02-2012
COUNTY CUMBERLAND
R
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
EMIT PAYMENT AND FORMS T0: ^ CERTIF.
JUDY ~ ^'
C MEMINGER REGISTER OF WILLS ~ w 7C7
466 ARLINGTON RD 1 COURTHOUSE SQUARE pp
CAMP HILL PA 17011-2106 ~ rn n
CARLISLE PA 17013 ~~< ~~r_-`~
METRO BANK CSC` ~ Y'om' _~~
provided the de artment with the information below, which was used in calc Utz f` ~~
Records indicate that at the death of the above-named decedent, u~~y
you were a joint owner/beneficiary of this account. I oU are th
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may betduenh~tancertaax d, ,
notify the department of pouseGgf~ye
your relationship to the deceased by checking Box C in PART I below and writing spouse" PART 2.
If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy'to this f4obrfi~m'tand return
it to the above address. Please call 717-787-8327 with questions. yoU mU
COMPLETE PART 1 BELOW ~ $FF REVERSE SIDE FOR FILING ANA PAYMENT INSTRUCTIONS
Account No. 5369600990 Date
03-25-2005
Established To ensure proper credit to the account, two
Account Balance copies of this notice must accompany
$ 2, 989.03 payment to the Register of Wills. Make check
Percent Taxable X payable to "Register of Wills, Agent".
Amount Subject to Tax 50.000
1 , 494.52 NOTE: If tax payments are wade within three
Tax Rate X months of the decedent's date of death,
Potential Tax Due • 15 deduct a 5 percent discount on the tax due.
224.1 8 Arty inheritance tax due will become delinquent
PART nine wonths after the date of death.
Q1 TAXPAYER RESPONSE
tit ~ ~~~a~~`* . ~ ~ '~~lEN
A• ~y~ The above information and tax due as correct.
F~ Remit payment to the Register of Wills with two copies of this notice to obtain
C CHECK a discount ar avoid interest, or return this notice to the Register of Wills and
ONE an official assessment will be issued
BLOCK by the PA Department of Revenue.
0 N L Y B' ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
filed by the estate representative.
C• ~ The above inforwa 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
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
PART
perjury, I declare that the facts I
compl a to the best of/~/m~y~ knowledge and belief.
~ Y.1Pwl.LJ wAr O A .
A
DEBTS AND DEDUCTIONS CLAIMED
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of $
OF TAX ON JOINT/TRUST ACCOI
1
2 ~`
3 X
4 +~`
5
6
7 X
x S
reported above are true, correct and
HOME C ~' ~ 7) q ~ ~ - 9~ ~a
WORK C (-j) 94~-4f30
TELEPHONE NIIMRCo
DATE PAID PAYEE
DESCRIPTION AMOUNT PAID
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