HomeMy WebLinkAbout04-20-07 (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
NO. CD 008061
BRENNAN THOMAS A JR
1922 HIGH ST
CAMP HILL, PA 17011
-___un fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
ESTATE INFORMATION: SSN: 188-14-1 298
FILE NUMBER: 2107-0146
DECEDENT NAME: BRENNAN MARGARET
DATE OF PAYMENT: 04/20/2007
POSTMARK DATE: 04/19/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/2007
07113357 I $262.66
I
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TOTAL AMOUNT PAID:
$262.66
REMARKS:
CHECK#570
SEAL
INITIALS: OM
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
.
INi=ORHATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 07- 0146
07113357
03-28-2007
REV-1M3 EX AFP (It-DO>
:--'.-,,,,-!.., f':
'00 I HI I( < U AN Ii ~~l OF "ARGAR ET " .RENHAN
CLEpl,' Ac S.S. NO. 188-14-1298
On ,1\ '-', .
11PI'I/,"/'I~ 1"\("\'lr:-DATE OF DEATH 02-05-2007
, CI),'. ,- v. '.h)/ If Olru-.
'>"1 p -,~ ...1iI". CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
Ii] CHECKING
o TRUST
o CERTIF.
. ~ ";
THOMAS A BRENNAN.JR
1922 HIGH ST
CAMP HILL PA 17011
REMIT PAYMENT AND FdRMi To:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SOVEREIGN BANK has provided the Oeparhent with the infol'llation listed below which has been used in
calculatinu 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 froa the financial institution, attach a copy
to this fol'll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~onwealth
of PennSYlvania. Questions Ray be answered by callin9 e717} 787-8327.
COMPLETE PART 1 BELOW · · · SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0571110053
Date
Establ1shed
10-23-1989
To insure proper credit to Your account, two
e2} copies of this notice Rust aCc~pany Your
payaent to the Reuister of Wills. Make check
payable to. "Reuister of Wills, Auent".
Account Balance
Percent Taxable
Amount SUbject to Tax
Tax Rate
Potential Tax Due
x
12,288.40
50.000
6,144.20
.045
276.49
TAXPAYER RESPONSE
NOTE. If tax pay.ents are aade within three
e3} aonths of the decedent's date of death,
YOU aay deduct a 5% discount of the tax due.
Any inheritance tax dua will beco.e delinquent
nine e9} .onths after the date of death.
x
PART
[!]
The above infol'llation and tax due is correct.
I. You.ay choose to reait payaent to the Reuister of Wills with two copies of this notice to obtain
a discount or avoid interest, or YOU aay check box "A" and return this notice to the Reuister of
Wills and an official assessaent will be issued by the PA Departaent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
If YOU indicate a different tax rate, please state YOUr
relationship to decedent:
B. c:J 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.
C. c:J The above infor.ation is incorrect andlor debts and deductions were paid by You.
You aust coaplete PART ~ andlor PART [!] below.
PART
l!J
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount SUbject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
l!l
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
$2C1>2. Cpr(;.
AMOUNT PAID
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
x
6
7
8
x
PAYEE
DESCRIPTION
..
of perjury, I declare that the facts I have reported
of my knOWledge and bel1ef. HOME ( ,
WORK (
TELEPHONE
TOTAL CEnter on Line 5 of Tax Computation)
.
above are true,
) 7(0 I-
)
NUMBER
Correct and
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