HomeMy WebLinkAbout08-16-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2130601
HARRISBURG, PA 17128-0601
REV-1162 EX(11.96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
GRACI MARGARET M
365 WALTON ST
LEMOYNE, PA 17043
.____n_ fold
ESTATE INFORMATION: SSN: 307-12-9770
FILE NUMBER: 2106-0724
DECEDENT NAME: COLENE SUSIE A
DATE OF PAYMENT: 08/16/2006
POSTMARK DATE: 08/1 6/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 05/06/2005
NO. CD 007108
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
06122117 I $1, 122. 13
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TOTAL AMOUNT PAID:
$1 , 122.13
REMARKS: MARGARET M GRACIE
CHECK# 1100
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8060l
HARRISBURG. PA l71Z8-060l
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO.
ACN
DATE
21--D~ o1~}
06122117
05-18-2006
REV-1545 EX AFP 109-GaI
EST. OF SUSIE A COLENNE
S.S. NO. 307-12-9770
DATE OF DEATH 05-06-2005
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
D CHECKING
~ TRUST
o CERTIF.
MARGARET M GRACI
365 WALTON ST
LEMOYNE PA 17043
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Department with the inforllation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent. YOU were a joint owner/beneficiary of
this account. If yOU feel this information is incorrect. please obtain written correction froll the financial institution, attach a copy
to this forll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COllllonwealth
of Pennsylvania. Questions may be answered by callJng (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5080041269 Date 10-18-1993
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
24,936.20
100.00
24,936.20
.045
1,122.13
TAXPAYER RESPONSE
To insure proper credit to your account. two
(Zl copies of this notice IIUst aCCOllpany your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax paYllents are lIade within three
(3) lIonths of the decedent's date of death,
you lIay deduct a 51. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
[!]
A.
[ CHECK ]
ONE
BLO&K B.
ONLY
c.
r.ilThe above information and tax due is correct.
~l. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest. or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
c=J The above inforllation is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION OF
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
x
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
declare that the facts I
belief.
have reported above are true, correct and
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