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Home My WebLink About03-13-07 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 L1PLES MARY 824 L1SBURN ROAD 410 CAMP HILL, PA 17011 -- fold ! I ESTATE INFORMATION: SSN: 190-14-1466 I FILE NUMBER: 2107-0239 i I DECEDENT NAME: L1PLES PAULINE I i DATE OF PAYMENT: 03/13/2007 I POSTMARK DATE: 03/12/2007 I COUNTY: CUMBERLAND DA TE OF DEATH: 01/16/2007 NO. CD 007896 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07108399 I $595.88 I I I I I I I I TOTAL AMOUNT PAID: $595.88 REMARKS: MARY L1PLES CHECI<# 335 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 1712B-0601 '* FILE ACN DATE NO.21 (:)1. ()~3q 07108399 03-02-2007 INFORMATION NOTICE AND TAXPAYER RESPONSE REV.1543 EX AFP C09-00) TYPE OF ACCOUNT i"""':> C~ = -J IiJ SAVINGS o CHECKING LViTRUST Q~CERTIF . EST. OF PAULINE LIPLES 5.5. NO. 190-14-1466 DATE OF DEATH 01-1~007 COUNTY CUMBERLA~~ "', =-r-, . REMIT PA~ ANIY90RHS TO,::) REGISTER OF ::WtbLS - . " 1 CUMBERLANDC~ ~OURYWHOUSE I::J CARLISLE, P~<.!lOI3u ,i .~, ~'Y'l MARY LIPLES 824 LISBURN RD 410 CAMP HILL PA 17011 ~ )'::i:J N --"1 N PNC BANK has p..ovided the Depa..tllent with the info...ation 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../beneficiar-y of this account. If you feel this info"lIation is inco....ect. please obtain w..itten co....ection f..oll the financial institution. attach a copy to this fO"1I and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax Laws of the COllllonwealth of Pennsylvania. Questi,,"s may be answer-ed by cr.1ling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5130105006 Date Established 01-14-1983 To insu..e pr-ope.. c..edit to you.. account. two (2) copies of this notice IIUst accOllpany you.. paYllent to the Registe.. of Wills. Make check payable to: "Registe.. of Wills. Agent". Account Balance Pe..cent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] x 31,361.11 16.667 5,226.96 .12 627.24 TAXPAYER RESPONSE NOTE: If tax paYllents a..e made within th..ee (3) months of the decedent's date of death. you lIay deduct a 5% discount of the tax due. Any inhe..itance tax due will becolle delinquent nine (9) .Months afte.. the date of death. x A. ~ The above info...ation and tax due is co....ect. ~1. You lIay choose to ..e.it payllent to the Registe.. of Wills with two copies of this notice to obtain a discount 0.. avoid inte..est. 0.. you lIay check box "A" and ..etu..n this notice to the Registe.. of Wills and an official assessment will be issued by the PA Depa..t.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been 0.. 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"lIation is inco....ect and/o.. debts and deductions we..e paid by you. You lIust complete PART ~ and/o.. PART ~ below. OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART [!] TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: 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 PART [!] DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCR I PTI ON AMOUNT PAID . \ TOTAL (Enter on Line 5 of Tax Computation) facts I have reported above are true, correct and Under penalties of perjury, I declare that the ~Plete to the best of my knowledge and belief. )~.t __~Jct-&/ HOME WORK (7/'7) 7""27-tfffb'2-- ( ) ~ TI:I I:DUnldl: IdIIMR~D nATI= . : , 4 ( , ~ , 'Il', I" ~ J..~. ) '( ~ h I \ ) 1 )/ f/ h (((J'f Ii ;\, '\\'\ \ ., .. 'l"'~ l"" rl V"'J, (( r, ff':"" ~'.*' " ........ t,~ ~,kt- lJ c, :> O:l ()') ",'>l ~ C~ </ <0, J: r'... g t':-j J,..f ;i 1t:f -'4,:1'- ("'{ r~ I f I Q .r- ~ - Qc~ s:- <l-... ~ ~- ~ :> '+ ,~~- ~ '-:1 J ~'j- ~~ ~ \f) --::> -l- ~ (f) - .l- ~ :) \ <:) - ~CJ --...J - ct. ,~ ~ ~cJ Cl ~ c+ ~ W <> s:_ ~ If) L ~ l ~ ~)~ .~ ~ d ~:)c) ~Cj a::: ']C) C ",',"LI,JUQ \J:1 '. ~'I ;~CJ :10 )JUJIJ ( 2 :2 Hd 8 I m"j.J LODl