HomeMy WebLinkAbout10-16-13 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
NO. CD 018256
KINGSBOROUGH BONNIE C
153 LOGAN ROAD ROOM 220
DILLSBURG, PA 17109
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
__________ ________
13143303 $63.30
ESTATE INFORMATION: SSN:
FILE NUMBER: 2113-1098
DECEDENT NAME: KINGSBOROUGH PEARL M
DATE OF PAYMENT: 10/16/2013
POSTMARK DATE: 10/15/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 06/16/2013
TOTAL AMOUNT PAID: $63.30
REMARKS: BONNIE KINGSBOROUGH
CHECK# 104
INITIALS: WZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES Penns Ivani Inhitance Tax pennsyLVBnia
a er
PO BOX 280601 Y
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response RED- Ex oo`ExE``oe-9�
FILE NO.21— 15
ACN 13143303
DATE 08-13-2013
Type of Account
P I'1 1 9 O Estate of PEARL M KINGSBOROUGH Savings
J_L SSN X Checking
Date of Death 06-16-2013 Trust
BONNIE C KINGSBOROUGH - ' County CUMBERLAND Certificate
RM 220 �fir�;jE�rj�' f✓ _: ;1
153 LOGAN RD
DILLSBURG PA 17019-99AKIBERLA1.'D CO. t)A
PNC BANK NA 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.5070094164 Remit Payment and Forms to:
Date Established 12-26-1990 REGISTER OF WILLS
Account Balance $2,813.13 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $ 1,406.57
Tax Rate X 0.045
Potential Tax Due $63.30 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 ❑No tax is 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 E I 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 r_J 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 F-] 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.
� � _w; v.
o:
�. � a
M �
1 a ' '
�.
,.-.
,�.
M � +
\c
"•
� { _
� 1
k � \
�1(
G ("��
'• 'M] �`�
ti
_� D
,, ��
i
i ��