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Home My WebLink About02-26-13COMMONWEALTH OF PENNSYLVANIA REV -1162 EX(11 -96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128 -0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017228 NORTON ALISA M 2 THYME COURT MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: SSN: 198 -30 -1216 FILE NUMBER: 2112 -0246 DECEDENT NAME: WALLACE SHIRLEY ANN DATE OF PAYMENT: 02/26/2013 POSTMARK DATE: 02/25/2013 COUNTY: CUMBERLAND DATE OF DEATH: 02/13/2012 REMARKS: CHECK #1196 SEAL 13031067 $2.73 TOTAL AMOUNT PAID: INITIALS: DMB RECEIVED BY: REGISTER OF WILLS $2.73 GLENDA FARMER STRASBAUGH REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128 -0601 RECOROEO OFFICE of REG9 L OF . s Pennsylvania Inheritance Tax Information Notice And Taxpayer Response 613 FEB 26 fill 11 57 ALISA M NORTON 2 THYME CT CLER, g MECHANICSBUR )P�# A 7 ,-31 99 U R T CUMBERLAND GO., PA pennsyLvania DEPARTMENT OF REVENUE REV -1543 EX DocEXEC (88 -12) FILE NO. 2112-0246 ACN 13031067 DATE 01 -25 -2013 Estate of SHIRLEY A WALLACE SSN 198 -30 -1216 Date of Death 02 -13 -2012 County CUMBERLAND Type of Account Savings Checking Trust Certificate MEMBERS 1ST FCU SAVINGS provided the department with the information below indicating that at the death of the above -named decedent you were a joint owner or beneficiary of the account identified. PART Step 1: Please check the appropriate boxes below. A [_� No taxis due. B X The information is correct. C F-] The tax rate is incorrect. (Select correct tax rate at right, and complete Part 3 on reverse.) D F-] Changes or deductions listed. E F� Asset will be reported on inheritance tax form REV -1500. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. The above information is correct, no deductions are being taken, and payment will be sent with my response. Proceed to Step 2 on reverse. Do not check any other boxes. X4.5% 1 am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. 12% 1 am a sibling of the deceased. 15% All other relationships (including none). The information above is incorrect and /or debts and deductions were paid. Complete Part 2 and part 3 as appropriate on the back of this form. The above- identified asset has been or will be reported and tax paid with the PA Inheritance Tax Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. Remit Payment and Forms to: Account No. 54 Date Established 06 -16 -2004 REGISTER OF WILLS Account Balance $121.19 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 60.60 Tax Rate X 0.045 Potential Tax Due $ 2.73 NOTE": If tax payments are made within three months of the decedents date of death, deduct a 5 percent discount on the tax With 5% Discount (Tax x 0.95) $ (see NOTE *) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1: Please check the appropriate boxes below. A [_� No taxis due. B X The information is correct. C F-] The tax rate is incorrect. (Select correct tax rate at right, and complete Part 3 on reverse.) D F-] Changes or deductions listed. E F� Asset will be reported on inheritance tax form REV -1500. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. The above information is correct, no deductions are being taken, and payment will be sent with my response. Proceed to Step 2 on reverse. Do not check any other boxes. X4.5% 1 am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. 12% 1 am a sibling of the deceased. 15% All other relationships (including none). The information above is incorrect and /or debts and deductions were paid. Complete Part 2 and part 3 as appropriate on the back of this form. The above- identified asset has been or will be reported and tax paid with the PA Inheritance Tax Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay, the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 81/2" x 11" sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation)--T$ IVYOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717 - 787 -8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND /OR SPEAKING NEEDS ONLY: 1- 800 - 447 -3020 RECORDED OFFICE OF REGISTER OF VVI! iS 2613 FEB 26 flil 1 57 CLERK Orr- ORPHANS' COURT CUMBERLAND CO., PA U (:D (P iTj W4