HomeMy WebLinkAbout04-20-07
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
BRENNAN THOMAS A JR
1922 HIGH ST
CAMP HILL, PA 17011
-------- fold
ESTATE INFORMATION: SSN: 188-14-1298
FILE NUMBER: 2107-0146
DECEDENT NAME: BRENNAN MARGARET
DA TE OF PAYMENT: 04/20/2007
POSTMARK DATE: 04/1 9/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/2007
NO. CD 008060
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07113359 I $199.11
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$199.11
REMARKS:
CHECK# 567
INITIALS: OM
RECEIVED BY:
SEAL
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPt~ 2B0601 ___
HARi!sBURG, PA ,.1:>712B-0601
,. .
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 07-0146
07113359
03-28-2007
'~ '-)
-~J Qj
___' 1--.,-
,:~~r:; ~=~~~
C:5uj
,/9cc
~~
C>
C"V
C".c
Q
~
r0-
C"::)
THOMAS
1922 HIGH
CAMP HILL
REV.1S41 EX AFP (It-OO)
~
u_ r....:~
',--'
"---" c.J
&if?
d~j~:
L!
Cc
C,
A BRENNAN
ST
TYPE OF ACCOUNT
o SAVINGS
Ii] CHECKING
o TRUST
o CERTIF.
EST. OF MARGARET M BRENNAN
5.5. NO. 188-14-1298
DATE OF DEATH 02-05-2007
COUNTY CUMBERLAND
JR
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 170ll
SOVEREIGN BANK has provided the Deparbent with the inforaation 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 fr~ the financial institution, attach a copy
to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth
of PennSYlvania. Questions a~ be answered by e~lling (717) 787-B327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1051084946
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
Date
Established
05-25-2004
To insure proper credit to your account, two
(2) copies of this notice aust accoapany your
payaent to the Register of Wills. Make check
payable to. "Register of Wills, Agent".
x
27,944.58
16.667
4,657.52
.045
209.59
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 in~.ritanc. tax due will becoae delinquent
nine (9) aonths after the date of death.
x
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
The 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 obtein
a discount or avoid interest, or you aay 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.
B. c:l The above esset 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 andlor debts and deductions were paid by you.
You aust coaplate PART 0 andlor PART [!] below.
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
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[!]
DATE PAID
x
x
DEBTS AND DEDUCTIONS CLAIMED
1,ccr.l/
AMOUNT PAID
PAYEE
DESCRIPTION
.
Under penalties of perjury, I declare that the facts
~ complete to the best of my knowledge and belief.
~
TAXPAYER
have reported
HOME (It
WORK (
TELEPHONE
above are true,
) 7t'i I-
)
NUMBER
DATE
...
~1
~ :
.. ..
fi:St
'2 ~ ~
.. 'J.. ~
't7.... ..
.~ ~;;;
~ -e ';J
(J L. ;:
~5~
.... ~
.g:s~
-:; '; g
c: I! ~
f! l .~
lU ~,..., "0
&J of.J.r;:: ...,
g"~ ~
~-gg ~
(J II) c: 'IJ I
:J l:r C1I "0 0
~fi~ c:"'"
b 0::' IV 0
-g ....: ':; ~ ::
...~
ro g. ..u r; t... ...
tr(J~~8~~
~O~'''''~O'
~~fo:Q):;7v
uc:o.o.Qc:.g
~.~t!L.~~""-;
ttJ "" '!If .:! ..., >< .,...,
CD . o...~ :t:: "g
o c: CII C) L. c: ,.."
~ 0 ~ <II 0 lD If,..
o ~ Dt: c: fl) 0
c: U QI: U ::J
l:i:E.Q~:
~~1D8:~5
.~ If) .f; L. .s:: CZl <<I
C' "0 If., (II )0 ..
ag'~f.~~g t
.,..,: ::J.f,J oIJ c: t
l:Q:~'tgi: k
~ L. 5 c.. &J VJ & u
a. Q.I 0 'rot ~ c:
. ~ u l.s:: 0. If,.. .,..,.
o a. ...,"" C&I 0 '" (
u ~ l"", c: L..,., .,..,
Et-;:;::l.!i
c: CII Q .,.., ~ L. 1: ~
.~:5~5,':;~:' ..0
1D~.r;::f!~~~ .P~.
" ~ ~ 't7 _ c: o.
~'""f""a Qt~ .,..,=f
.~ t ,,0 ~ -: :S l ~ g .~
rot II)' (II '" .,., :=.f; ~
GJ 0.. ..., >< ff1 ~ 0 '" c:
:5......~IJ.jQlb~,.jc:.~;:,
..... ..0 : :: :E ~ c: .g ell QI 8 .
,.."jtO::':!J""';:J~:5:5:;
, :' ~ CII ~ ..... 0 .,., c:
"f{~oIJit, f'-Q....,-IoJ....L.
.\r::'OOO::l!Q.a1:JCII'O)O~
~Z""~~&fi~(.J.~"'l
-'c;Xo'-' ""'~b~
l!Q'''''.:Jt::S~~:o(,Jk~:
l!Q I- 0 c: u.....,.,
. uGJ<<tli't;l.f..
N 0
r
;.;
~'Y' ~,Z'~l ,"h';cJ\ \" ,,/
,~.'(,; ~\II~: ~tJ: If. J~/1f1 ~~l't~~t"'tt/~'II ~~'1I ~11;'ff~"!~;t f
,f
/~ 7( .
~~b .;/_-_. ~ \-,
'j M~/1' ~;", .1 '
('f- , " 'i:J..
., ;,~,.~"I'" <,Br;~l.Q.:;l. ., 1, ~"" '. "'$'", ' .~, ,"''t", ',','
)\\~, 1~~?,~_I~=.~,l,' 1\', ifo ~ ~11{.(:-l1J
.r;;j,';3:~~':~~:M>~?'(:f!F' _~~~~~ ~::z, ,,/ ~ ' ,'-'
',,~:i:,..ti2'- '. , - '~ v - / ",' - ~- , , '" : , 1_
"'''~U-c;:x::/'_ ,----- y --, '''(0 f ff!\l~'" ',J "'"":--"\
::~~""",',,,;< 'Q! " ,:;:) _ (""; , _ r ~ ~ ..\It ,~\ .J(.../~
; ) ,.( '. ".~ ( u ,Y - ~ I ~ V ' '{, '
:~:~ ,~ " ., ;~l>tNt(cJq~,~~#ri: t
'--~;;"'~"" '.,- "~~'( ': ,I'> " ," ,,' i , '"
} ~. ",.,:(... 'l'i",iWcf. '~L~ l:td:y ,6l:
f{ 'v- -' ~(',,_ ..',"" "\ .
' "~-.,.,,;:' . '; ~~. ~ t-'........ ""~ 'oC1'W~~~'U~M>
(~-,"""::-:.-~~~ - vr"-'-_-,""'':~l:!',...-_-t::!..."
f---,-~,,-:-"-~l' "y, . "" I , , '",
--;-",~. I, '\ '/ ~ ". .J ? ' '
,'<, .
",
'r-:-
...
..
"
c.
o
...
c:
....
c.
a
....
c.
Q
C.
..
..
~
~-~:1,t',~,~',
~,._~ _.,,-~ C'_
c:
o
't7
..
.,
..
.Q
..
c:
o
...
.,
..
c.
..
...
c:
....
c:
....
.c:
...
....
:>
..
...
.Q
..
"
....
...
Q
Q
..
.c:
...
....
:>
I-
:<<:
Lu
~
CI)
CI)
Lu
CI)
CI)
<f
>(
::
~
o
....
I-
~
Q:
o
LI.
~
....
CI)
~
o
....
l-
t)
:;,
Q:
I-
CI)
~
....
C!J
~
....
I-
Q:
o
Q.
I.J.J
Q:
--=------~.
'';.-
r
o
...
..
...
.Q
..
~
...
I.J.J
CI)
~
o
Q.
CI)
I.J.J
Q:
Q:
I.J.J
>-
:
~
~
.....
I-
Q:
:
"j