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Home My WebLink About11-09-12."' ~ ~' (PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIOUgL razes I NFORMAT I O N NOTICE; PD Box z99s91 FILE N0. 21 12-0958 HARRISBURG Pl1 17129-0601 Pe ~~N~3flliii ~ 1 ,~' ~~= AND OEPAa Ewrpfa§vwwup ;; ~ ~ TAXPAYER RESPONSE ACN 12152457 ae ai Ex un'rua.,» _. ~~ DATE 09-21-2012 ~, ,~~~1 `~~'~.~ `9 P"', ,(• ~G TYPE OF ACCOUNT EST. OF DOROTHY P PICCOLO .. SSN 160-16-1992 ^ savlwcs _ DATE OF DEATH 12-31-2011 ® CHECKING ', CODNTY ~ TRUST (' ~~ ~~~ " n CUMBERLAND Ct1~~h ~f~/,I~J ~~/„ FA. REMIT PAYMENT AND FORMS T0: ^ CERTIF. ELIZABETH PICCOLO 1206 MITCHELL DR REGISTER OF WILLS MECHANICSBURG PA 17050-3132 1 COURTHOUSE SQUARE ' CARLISLE PA 17013 PSECU Recortls indf ca to f.hat at the tleath provided the tlepa rtment with the information below, uhi ch was used in calculatin nOtif DD You were a joint owner/beneficiary of this account. If 9 the inheritance tax due. deceased and any amount other thanhezero ei sa reflected tbelow on the Potential Tax Due line, note no tax may be due, but you must if yoo bath eveetnertmecnt~aofpyo0r relati onshl You are the spouse of the it to the above atld Tess. please ca ie717 ~i87 ~83Die oche en deceased by checking Box C 1n PgRT I below and wri tin written correction from the financial institution, attach a co 5 OUSe" COMPLETE PART 1 BE OW * Ouesti ons, py to this form eoaTretu rn SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0160161 92-54 Date 01-20-1989 ~ EStablishetl To ensure proper credit to the account, Aceouni Balance '' copies of this notice oust two ' +t 1 , 209.13 paynent to the Re accompany Percent Taxable sister of Wills. Make check ~( pav able fo "Reei Bier of Wills, Agent". Amount Subject to Tax ~ 16.667 Tax Rate '' '~ 201 .53 NDTE, If taz pavnents are matle within three '. X months of the decedent's data of death, Potential Tax Due • 15 detluct a 5 pe rcant discount on the tax due. ' '~ 3 0.23 Anv inheritance taz duo will become tlelinouent PART nine nonths after the tlate of death. 1^ TAXPAYER RESPONSE A• ~ The above inf ore ation antl tax due is Correct. j Remit payment to the Repi star of Wills with two co ies of CHECK ~ la discount or avoid interest, or return this notice to this notice to obtain ONE jam official assessment will be issued the Register of Wills and BL DCK by the Pq Deparkment of Revenue. ONL Y B' ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return fil~tl by khe estate representative. C. ~ Theabove inf orna ton is incorrect antl/or debts and tleductions were ConP'l ate PART ~ and/or PgRT ~ paid. below. PART If Sn di catf ng a diff rent tax rate, please state relationship to tlace•le nt: __ TAX RETURN - CALCULATI ON °- ---- LINE 1. Date Established ~' 2. Account Balance 3. Percent 'taxable ~~ 4. Amount Subject to Tax'. 5. Debts antl Detluctions 'I 6. Amount Taxable ', 7. Tax Rate '' 8. Tax Dua I PART -~~ DATE PAID PAYEI~I 1Nrs DEB 7S AND DEDUCTIONS CLAIMED DESCRIPTION iuiaL CEnter on Line 5 of Tax Computation) Untlar penalties of pe rj ury,l I declare khat 8 comp etdFto kh~ be~f m~ the facts I reported above are true, <:o rre ct a r/ Y n wled9e antl ball ef. AMOUNT PAID r ~ Debts and Deductions Date Paid Payee __ 1/2/12 GiantFoad Store ~r meeting at house with and funeral director Priests, organists, altar cash; gift envelopes servers at Stj Joseph's Church Giant Food 5 ore postage stamps for bills, thank you notes, misc. expenses 3arbara Ma igan Preston -18 reimbursement for incidentals V Walnut St. Mechanicsburg and serving meals on two ~A occasions :ommunity L fe Team EMS Date of Service 11/28/11 'Koste Villa f~ Am ul char e Memorial Mass Luncheon oyer's Flow rs and Gifts wreath for um table ichardson F neral Home Funeral Home partial pay Innacle Hea h Hospital Date of Service 12/22/11- nnacle Heal Hvrisb r h it I bill h Med Services Date of Service 12/22/11 - chardson Fu eral Home funeral home balance due r ~arMerica prescription drugs squehana T wnship EMS date of service 12/28/11- Dept of Re nue ambulan_,___ ce b~_ Pennsylvania personal Income thopedic Ins kute of PA Dates of service 11/1/11 and 11/8/11-steroid shots in knee :holic Cemet ties opening ground at grave site ve Garden Post-interment luncheon Iden Living N rsing Home - post-surgical wre e Ridge Mou Lain ~acle Health Hospital Dates of service 11/19 -11/28/11 'n Balaban co- attorney fees islet of Wills inheritance tax form and Max Paid TOTAL: $7,012.78