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Home My WebLink About10-29-13 (2) COMMONWEALTH 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 N0. CD 018335 EVERT CONNIE 141 TALL PINE DR FAYETTEVILLE, GA 30214 ACN ASSESSMENT AMOUNT CONTROL NUMBER oN ---------- -------- 13155060 $46.81 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-0144 DECEDENT NAME: EARLEY DOROTHY J DATE OF PAYMENT: 10/29/2013 POSTMARK DATE: 10/26/2013 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2013 TOTAL AMOUNT PAID: $46.81 REMARKS: CHECK# 1151 INITIALS: DMB SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES Penns lvania Inheritance Tax Dennsytvania PO BOX 280601 y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response " ""U°°""` FILE NO.2113-0144 RECORDED OFrlrE OF ACN 13155060 DATE 10-17-2013 29 fjmi 1, 1 1 2 Type of Account Estate 2 DOROTHY J EARLEY Savings �� SSN GLERn X Checking Date of Death OR,'HW; S' COURT County CUMBERLAND Trust GORDIE EVERT County CUMBERLAND Certificate 141 TALL PINE DR e F I t :�p �,3 n FAYETTEVILLE GA A.21f49_IP083'' EE PATR IOT BOND 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. Account No.0 Remit Payment and Forms to: Date Established 01-30-2013 REGISTER OF WILLS Account Balance $ 1,040.16 1 COURTHOUSE SQUARE X Percent Taxable 100 CARLISLE PA 17013 Amount Subject to Tax $ 1,040.16 Tax Rate X 0.045 Potential Tax Due $46.81 NOTE`: If tax payments are made within three months of the decedent's 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. 1 A F-]No taxis due. 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. B The information is- The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C ❑The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent,child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E F�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. October 25, 2013 RECORDED fii'FICE OF 3 OC. 29 AN 11 1J 3 Estate of Dorothy J. Earley SSN 202-20-6802 C L E_ "' C F 0RI-1-Uai',S' CuORT Date of Death 01-30-2013 CUf.iBERLUr CO., PA County Cumberland To Whom It May Concern: We received the Pennsylvania Inheritance Tax Information Notice and Taxpayer Response Form yesterday, October 24, 2013. The form was dated October 17. It was postmarked October 21. The return date, without a penalty, is October 30. 1 called and spoke with Sheila explaining our dilemma. We have lived in Georgia for over 40 years and it usually always takes seven days for mail to get from here to PA, but never that long to go from PA to GA. Go figure. The other situation is that our grandson, Gordy Evert (Gordon E. Evert) does not live with us anymore. He lives in south GA. There is no way it would get to south GA for his signature and be postmarked by the deadline. Sheila said I could sign his name, along with mine as well, and attach a note explaining the situation. Anyway, it will be postmarked before the deadline but will not be received by the deadline. If you need to reach me, please call 770-461-4491. If you need to reach Gordy, his cell phone number is 478-538-1413. Thank you so much for your help and understanding in this matter. Sincerely, Connie E. Evert Grandmother of Gordy Evert Enclosures: Two completed forms of the PA Inheritance Tax Information Form One check in the amount of$46.81 ' n�A Y � w .a C7 f? •y f w # tt tai t ui ~' lz� _ � s" y a. �y W < zz �r;