HomeMy WebLinkAbout04-26-07
COMMOIlt/EAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 m Yof
07116377
04-11-2007
REY-1511i3 EX AFP (09-00>
7np7 BPr; r:r
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EST. OF CHARLES WIBLE
5.5. NO. 204-30-7428
DATE OF DEATH 02-25-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
Ii] CHECKING
o TRUST
o CERTIF.
SCOTT WIBLE
LOT 31
82 LINDA DR
MECHANICSBURG PA 17050
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Depart..nt with the info,..ation 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 froa the financial institution, attach a copy
to this fo,.. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth
of PennSYlvania. Questions aay be answered by calling (717l 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 196031-11
Date
Established
08-10-2000
To insure proper credit to your account, two
(2l copies of this notice aust accoapany your
payaent to the Register of Wills. Make check
paYa tOI "Register of Wills, Agent".
PART
[!]
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
922.96
16.667
153.83
.045
6.92 - S%::t.~7 nine
TAXPAYER RESPONSE
x
[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 obtain
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 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 inforaation is incorrect and/or debts and deductions were paid by you.
You aust coaplete PART ~ and/or PART~. below.
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
PART
(!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
x
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation)
.
Under penalties of perjury, I declare that the facts I
lete to the best gf my knowledge and belief.
,4~
SIGNATURE
have reported above are true, correct and
HOME (7/7 ) ~ql- /09)
WORK (?n ) <f-ve- 3/y(,/
TELEPHONE NUMBER
-,</"/R'O 7
DATE
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
WIBLE SCOTT
LOT 31
82 LINDA DR
MECHANICSBURG, PA 17050
-------- fold
ESTATE INFORMATION: SSN: 204-30-7428
FILE NUMBER: 2107-0404
DECEDENT NAME: WIBLE CHARLES
DATE OF PAYMENT: 04/26/2007
POSTMARK DATE: 04/19/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/25/2007
NO. CD 008081
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07116377 I $6.57
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1102
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$6.57
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
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