HomeMy WebLinkAbout01-08-07 (2)
COMMONWEALTH 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
HOCUTT KElLl
2411 TRACY CIRCLE
HARRISBURG, PA 17112
_nnn_ fold
ESTATE INFORMATION: SSN: 164-30-2957
FILE NUMBER: 2107-0005
DECEDENT NAME: MADDEN PHilLIP P
DATE OF PAYMENT: 01/08/2007
POSTMARK DATE: 01/06/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 11/02/2006
NO. CD 007657
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
06161732 I $1,500.31
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 2878
SEAL
INITIALS: CJ
RECEIVED BY:
REGISTER OF WILLS
$1,500.31
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
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,~,It,LEORMATION NOTICE
,I> ',," AND
"-TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21-0'1 ~OOO~
06161732
12-15-2006
REV-1545 EX AFP 'D9-DOl
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EST. OF PHILLIP P MADDEN
S.S. NO. 164-30-2957
DATE OF DEATH 11-02-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
~ TRUST
o CERTIF.
2007 JM,j -8
KELLI WHITLEY
C/O 733 OLD SLVR SPG RD
MECHANICSBURG PA 17055
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
FUL TON BANK has provided the Depart.ent with the infor.ation listed below which has baan used in
calculating the potential tax due. Thair records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this fo~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co.monwealth
"f PAnnsylv~ia. ~Jestions..y ba answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 018-0221131 Date 12-07-2004
Established
100.021.54
33.333
33.340.18
.15
5.001.03
TAXPAYER RESPONSE
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
To insure proper credit to your account, two
(Z) copies of this notice .ust accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
x
NOTE: If tax payments are made within three
(3) months of the decedent.s date of death,
you may deduct a 5% 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
BLOCK B.
ONLY
c.
[] The above information and tax due is correct.
1. 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.
[] 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.
~ The above information is incorrect and/or debts and deductions were paid by you.
~YOU must co~lete PART ~ and/or PART ~ below.
If you indicate a different tax r te. ple se 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
1
2
3
4
5
6
7
8
x
TAX
ON JO NT/TRUST ACCOUNTS
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DEBTS AND DEDUCTIONS CLAIMED
x
PART
[!]
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
~I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury. I declare that the facts I
complete to the best of my knowledge and belief.
Hv~
URE
I
$
have reported above are true. correct
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