HomeMy WebLinkAbout03-01-07
ccrJHv1CI\JvVEAL TH OF PENNSYLVANIA
LEF'L>.Rnv'lEi'H OF REVENUE
:'-"'-JSEJ.:-U -;F II'JDIVIDUAL TA>{ES
[)t:F-'T
F',C:..li1,28-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOLLIS CAROL A
ONE WEST SCHOOLSIDE DR
MECHANICSBURG, PA 17055
i
i ESTATE INFORMATION: SSN: 193-12-7988
! 2107-0073
I FILE NUMBER:
I
i DECEDENT NAME: BIANCO lULU E
I 03/01/2007
I DInE OF PAYMENT:
i
: POSTMARK DATE: 03/01/2007
I
I COUNTY: CUMBERLAND
! DA TE OF DEATH: 10/11/2006
I
--
NO. CD 007852
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $35.38
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$35.38
REMARI<S: RICHARD M HOLLIS II
CAROL A HOLLIS
CHECI<# 3007
INITIALS: AJW
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 Q'l \)'\)13
07102144
01-15-2007
REV-1S43 EX AFP (09-00)
EST. OF LULU E BIANCO
S.S. NO. 193-12-7988
DATE OF DEATH 10-11-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECK I NG
o TRUST
Iil CERTIF.
CAROL A HOLLIS
1 W SCHOOLSIDE DR
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PSECU has p~ovided the Depa~tment with the info~mation listed below which has been used in
calculating the potential tax due. Thei~ ~eco~ds indicate that at the death of the above decedent. you we~e a joint owne~/beneficia~y of
this account. If you feel this info~mation is inco~~ect. please obtain w~itten co~~ection f~om the financial institution. attach a copy
to this fo~m and ~etu~n it to the above add~ess. This account is taxable in acco~dance with the Inhe~itance Tax Laws of the Commonwealth
of Pennsylvania. Questions may De answereo by calling (717) 781-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0193127988
Date 03-12-1984
Established
To insure proper credit to your account, two
(2) copies of this notice must accompany you~
payment to the Registe~ of Wills. Make check
payable to: "Registe~ of Wills. Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
15,726.47
X 5.000
786.32
X .045
35.38
TAXPAYER RESPONSE
NOTE: If tax payments a~e made within th~ee
(3) months of the decedent's date of death.
you may deduct a 5% discount of the tax due.
Any inhe~itance tax due will become delinquent
nine (9) months afte~ the date of death.
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. r'\l The above info~mation and tax due is co~~ect.
~1. You may choose to ~emit payment to the Registe~ 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 Depa~tment of Revenue.
B. [] The above asset has been o~ will be ~epo~ted and tax paid with the Pennsylvania Inhe~itance Tax ~etu~n
to be filed by the decedent's ~ep~esentative.
C. [] The above info~mation is inco~~ect and/o~ debts and deductions we~e paid by you.
You must complete PART ~ and/o~ PART ~ below.
X
PART
[!]
TAX
If you indicate a diffe~ent tax ~ate, please state you~
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1- Date Established
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
PART
[!]
DATE PAID PAYEE
X
"-" 1I_,DEBTS.AMnkbEDUCTIONS
Jij, ,__ _, :\r::JjU
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.....-, .-...: :\)
CLAIMED
DESCRIPTION
AMOUNT PAID
LZ
-2 ':, I'
,OTAL
;r,:~;J : ~:IT/"
y "' 0';: ,.';UL.I
(Enter on Line 5 of Tax Computation)
$
sJ
Under penalties of
complete to the be t of
, :'J
perjury, 'declare fhat t'he facts
my knowle ge and belief.
\
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