HomeMy WebLinkAbout94-00149
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REV-1543 EX AFP (1-911 *'
., COHI'tOHWEAL TH OF PENNSVLVANIA
t ' bEPAR\'1ENT OF REVENUE _
. BURl.,U OF INDIYIDUAL TAKES
. DEP1. 280601 '
HARRISIIUAC, Pi 1712'-0601
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
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n\-I 't,:,';
ESTATE OF KIRETA
S.S. NO. 191-18-4981
DATE OF DEATH 11-24-93
COUNTY CUMBERLAND
'9.'1 FEB 17 J:11 :::3
Cle.: KIRETA c.; t
CurnL ,.2020 LENa'" ST
., CAMP' HI'LL?'\
GEORGE J
PA 17011
FILE
ACN
DATE
NO. 21- q,/- /'1'7
94103181
01-29-94
TYPE OF ACCOUNT
F ~ SAVINGS
CHECKIHG
TRUST
CERTIFICATE
REnIT PAynENT AND FORnSTO.
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
JOSEPH
DAUPHIN DEPOSIr BANK & ha. providlld thll Dllpllrt.llnt with thll Jnforl.tion Ultlld blliow which hal b.lln u'lId in ulculatlng th.
potllntl.l hue du..Th.Jr ncordl Indlcat. that at thll duth of thll .bov. dllclldllnt, ~OU .wllrll . joint own.r/b.n.ficlar~ of thh IccOunt.
If YOU f.1I1 tl'l1l Infor.IUon is incorr.(lt, plllGIII obhln written corr.ctlon frol th. finlncial In.tltution, Ithch a cop~ to thh forI
:ili~ rc~~;,,:"i It t.. t!':~ :'=:I~': ..:fdru,. ThjJ .:.,;,;...;t :10- 1,,;,..1..... :., ......un.:..-.... _Ji.I. ll.. I.Ii... It..."" Tel... i...... lo.Iy. \11" C'''IICH1...l.tn of
FoIIM'Ylv.1i..
au..Uon, II>> be M'wered b~ calling (717) 7B7.8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0017866731 D.to 03-12-84
E.bblhh.d
2,037.74
50.000
1,018.87
.15
152.83
TAXPAYER RESPONSE
"", ~I!ILURI!TO ..' RESPOND \ ifILL RI!SULT< IN AN ,'OF.F ICXAL.,.AX\ASSESSHEH1'i BASI!II.".ON''l'HXS ... HOrXCI! i
Account B.lanel
P.rclnt rex.bll
Anount Subj.ct to T.x
r.x R.t.
Pot.nt!.l r.x DUI
x
x
PART
ill
To Inlure proper cradit to your account, two
(2) copia, of this not Ie. IUlt ICCOlPlny ~our
pay..nt to thl R.glstar of Will.. "Ike chick
paYllble to: "Reght.r of Willi, Allllftt".
NOTEI If talC pllYI.nts ara lad. wi thin thru
(3) .onth, of tha deced.nt', dllta of d..th,
~ou .ay daduct III 5;: di~ount of th. talC due.
An>> inl'ler Itance tIIIx due will becoe. lHillnQuent
nlna (9) enthl after the dlta of death.
[ C~~~K ]
BLOCK
ONLY
A. ~ The abolle lnforaatlon Ind tslC du. I, correct.
1. You la~ choo... to r..1t pl~lIOnt to the Regllter of 'lUll, wit!'! two topl., of this notice to obtain
. dl'count or Ivoid int.r.lt,.or YOU a..~ cheek bolC "A" IIld raturn this notlc. to th. R.gi,t.r of
WUb and an official a.......nt ..Ill be lUUlld by the PA Depart'lInt of RevllnU..
I. 0 TI'I. .bove ...et h.. be.n or wUI bll reported and talC paid with tha PII1I'I'Ylvanie InhtirltW\Ce TelC r.turn
to be fUed by the; decedent'. rapratentativ..
c. 0 The abovl infor.atlon 11 Incorrect ancl/o~.bts end deduction. ..er. paid by you.
You IUlt coepht. PART [!] and/or PART t!J bllow.
If you indie.t. . diff.r.nt t.x r.t., pl.... It.t. your
r.l.tion.hlp to dlc.dent:
PART
~
lAx RE1URN - COMPUTA'UOH
LINE 1. D.t. E.t.blllh.d
2. Account a.l.ncI
5. Plrce"t r.xabl.
4. Anount Subject to rax
S. Debt. and O.ductions
6. A.ount r..abll
7. r.K Ret.
I. hK Du.
OF lAX ON JOINr~TRUST ACCOUNTS
1
2
3-L-
4
5 -
6
7-L-
a
PAD'.
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
PART
~
DATE PAID
PAYEE
DESCRIPTION
~
.......OFFICIAL.USE '..9NLV> O.AAF
.PADEPARTHENlOFREVENUE .
AMOUNT PAID
I-
I
TOTAL IEnt.r on Line 5 of Ta. Co.~t.tion)
j
.
Undlr ~ltl.. of p.rjury, I d.cl.r. th.t the fect. I h.v. rlPOrted above Ir. true, correct Iftd
~O"I.t. to tho b~ 0' .Y k~O"J.d"vond boU..'. "II}. HOME (~:-' 1 ~: 9 "V (, /
;?AA;-T{<,~.t.r'4 - C-;.t:.:4'-t'e d/L<-uli- /. fA. WORK ( . 1._
fAkpAYE S NATURE TELEPHO E NUMB
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