HomeMy WebLinkAbout02-02-07
COMMONWEALTH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
8UREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
~_ :rrlif-N,FORMATlNODN NOTICE
~': ,)1 . '~;T~XPAYER RESPONSE
FILE
ACN
DATE
NO.21 Of (.,"L
07103207
01-24-2007
., ,," _::.: L '
REV.1S43 EX "AFP "':00>
2001 fEB -2 Pt1 2: 49
EST. OF MARGARET H BOWSER
5.5. NO. 191-30-1710
CLER\< OF T DATE OF DEATH 12-29-2006
ORPH,AN'S caUR I COUNTY CUMBERLAND
CU!v~2r:'-:>i C'~I PA
TYPE OF
ACCOUNT
o SAVINGS
[Xl CHECKING
o TRUST
o CERTIF.
MARY L VALCIS
217 WALNUT DALE RD
SHIPPENSBURG PA 17257
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ORRSTOWN BANK has provided the Oepartaent with the infoMlation 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 inforaation is incorrect, please obtain written correction froa the financial institution, attach a cOPY
to this fOMl and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coaaonwealth
uf Pennsylvania. QU8stion$ aey be answered by calline (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 103001326
Date
Established
10-12-2000
To insure proper credit to your account, two
(2) copies of this notice aust accoapany your
payaent to the Register of Wills. Make check
peyable to. "Register of Wills, Agent".
x
6,128.24
16.667
1,021.39
.15
153.21
TAXPAYER RESPONSE
NOTE. If tax payaents are aade within three
(3) aonths of the decedent's date of death.
you aay deduct a 5% discount of the tax due.
Any inheritance tax due will becoae delinquent
nine (9) aonths after the date of de.th.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
PART
ill
[CHECK ]
ONE
BLOCK
ONLY
A. ~he above inforaation and tax due is correct.
1. You aay choose to reait payaent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you lIay check box "A" and return this notice to the Register of
Wills and an official assessaent will be issued by the PA Departaent of Revenue.
8. c=l 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. c=l The above inforaation is incorrect and/or debts and deductions were paid by you.
You aust coaplete PART ~ and/or PART ~ below.
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of Tax Computation)
.
of perjury, I declare that the facts
of my knowledge and belief.
j
have reported above are true, correct and
HOME (7/7 )53 0 -S-q S-O
WORK () ~W(J1'):;
TELEPHONE NUMBER D E
COMM ONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
VALCIS MARY L
217 WALNUT DALE RD
SHIPPENSBURG, PA 17257
_____n_ fold
ESTATE INFORMATION: SSN: 1 91 -30-1 71 0
FILE NUMBER: 2107-0062
DECEDENT NAME: BOWSER MARGARET H
DA TE OF PAYMENT: 02/02/2007
POSTMARK DATE: 02/02/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 12/29/2006
NO. CD 007772
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07103207 I $ 1 45 .55
I
I
I
I "
I
I
I
I
TOTAL AMOUNT PAID:
$145.55
REMARKS:
CHECK# 431
INITIALS: JA
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS