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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
07-355
FILE NO. 21 -
ACN 07108402
DATE 03-02-2007
REV-1SIi;' EX MP (09-00)
I . .IL.L
CLC~-.< Ci=
EST. OF GRACE I HEPFORD
S.S. NO. 174-20-2902
DATE OF DEATH 06-21-2005
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IXJ CERTIF.
J i.;,/.)R 12 PI.
DIANNE G DILGER
4 CEDARVIEW DR
LEBANON PA 17042
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Departllent with the inforution 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 inforllation is incorrect, please obtain written correction froll the financial institution, attach a copy
to this forll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Comllonwealth
of Pennsylvania. ~uest1ons may be answered by calling C717} 787-8327.
COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 21001021677
Date
Established
02-24-1995
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
45,178.42
50.000
22,589.21
.045
1,016.51
TAXPAYER RESPONSE
NOTE I If tax paYllents are .ade within three
(3) months of the decedent's date of death,
YOU .ay deduct a 5~ discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) 1I0nths after the date of death.
x
PART
[!]
The above infor.ation and tax due is correct.
1. You lIay choose to re.it paYllent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or yoU .ay check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
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=l The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.Plete PART 0 and/or PART @J below.
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please 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
(I
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Compu~atlonJ
.$
Under penalties of perjurY, I declare that the facts I
complete to the best of my knowledge and belief.
T~ERslGN~~
have reported above are true, cOrrect and
HOME (/ '-1) ~13- <J.cQ..llJ
W~:~EP~ONE N~HBER ~ JjL;
KEITH L. KILGORE
PAUL W. KILGORE
JOHN D. ENCK
Law Offices
SPITLER, KILGORE & ENCK, PC
522 South Eighth Street
P.O. Box 1188
LEBANON, PENNSYLVANIA 17042
(717) 273-7621 (VOICE)
(717) 273-1693 (FAX)
ske@skelawfirm.com
CALVIN D. SPITLER
(I 942-2003)
THOMAS A. EHRGOOD
(1952-2006)
April 10, 2007
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
:::J
I"'...)
RE: Estate of Grace I. Hepford
S.S. No. 174-20-2902
DOD: 06/21/2005
f'.)
-v
U.,
Dear Sir or Madam:
Enclosed please find correspondence sent to the Department of Revenue as to
the above estate. In addition, please find enclosed payment of tax due with respect
to said notice as corrected in the amount of $1,016.51. If you have any questions,
please give me a call.
PWKIlms
Enclosure
cc: Dianne G. Dilger