HomeMy WebLinkAbout04-24-07
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 008070
RECEIVED FROM:
ANOKA CARL T. JR.
17 COURTLAND ROAD
CAMP Hill, PA 17011
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
___n___ fold
07500237
$45.10
ESTATE INFORMATION: SSN: 177-24-5745
FILE NUMBER: 2105-0722
DECEDENT NAME: ANO KA RUTH A
DA TE OF PAYMENT: 04/24/2007
POSTMARK DATE: 04/20/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 07/18/2005
TOTAL AMOUNT PAID:
$45.10
REMARKS:
CHECK#1387
INITIALS: DMM
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
SEAL
REGISTER OF WILLS
I
--
~
COMMONWEALTH OF PENNSYLVANIA
JEPARTM~T OF REVENUE
~BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 OS- 0722
07500237
04-04-2007
REV-1S4~A AFP (7-00)
EST. OF RUTH A ANOKA
S.S. NO. 177-24-5745
DATE OF DEATH 07-18-2005
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SECURITY
[i] SEC ACCT
o STOCK
o BONDS
:..-';. ;;.i i
',J ~,
CARL T ANOKA
17 COURTLAND ROAD
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SMITH BARNEY has provided the Department with the information 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 beneficiary of this asset.
If you feel this inforllation is incorrect, please obtain written correction from the transfer agent, attach a COpy to this form and
return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of PennsYlvania.
Questions Ilay be answe,-ed Dy calling (717) 767-8~2'i.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
x
1,867.63
50.000
933.82
.045
42.02
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice must accompany your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent"4
Account No. L259909
DOD Valuation
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
NOTE: If tax paYllents 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 becolle delinquent
nine (9) months after the date of death.
PART
[!]
above inforllation and tax due is correct.
You may choose to rellit payment 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 Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. DThe 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. DThe above information is incorrect and/or debts and deductions were paid bY you.
You Ilust complete PART ~ and/or PART ~ below.
x
If you indicate a different tax rate. please state your
relationship to decedent:
PART
[!J
TAX RETURN - COMPUTATION
LINE 1. DOD Valuation
2. Percent Taxable
3. Amount Subject to Tax
4. Debts and Deductions
5. Amount Taxable
6. Tax Rate
7. Tax Due
OF TAX ON ABOVE ASSET(S)
1
2
3
4
5
6
7
x
PART
[!]
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID
PAYEE
DESCR I PTI ON
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
$
perjury, I declare that the facts I ~reported above are ',true" correct and
knowledge and belief. c...6..L 'HO~E (It ~ ) LDO~ - Lf <eO./.(
UO<42 WORK () ~lo"""
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