HomeMy WebLinkAbout05-08-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
_n'.nl!! tYbF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 008130
SCHWEITZER JULIE M
8 MARY AVENUE
MECHANICSBURG, PA 17055
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
nnnn fold
07115541
$84.61
ESTATE INFORMATION: SSN: 211-22-6547
FILE NUMBER: 2106-0954
DECEDENT NAME: WOODS SAMUEL JR
DATE OF PAYMENT: 05/08/2007
POSTMARK DATE: 05/07/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 10/21/2006
TOTAL AMOUNT PAID:
$84.61
REMARKS: JULIE SCHWEITZER
CHECK# 5837
SEAL
INITIALS: WZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280'01
HARRISBURG, PA 17128-0'01
'*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 06 - 0954
ACN 07115541
DATE 04-06-2007
_1lEV'1~ EX)U:PU9-UO>
JULIE
8 MARY AVE
MECHANICSBURG
OF;~iH/',
M SCHWEITZ~~\
~J\....i.'
EST. OF SAMUEL WOODS
S.S. NO. 211-22-6547
DATE OF DEATH 10-21-2006
COUNTY, CUMB~RLAND
TYPE OF ACCOUNT
D SAVINGS
[il CHECKING
D TRUST
D CERTIF.
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:./ - tj I-r;! ~~i: ,,j 0
PA 17055-9717
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
INTEGRITY BANK has provided the Depart.ent 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 info~ation is incorrect, please obtain written correction fro. 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 Co..onwealth
of Pennsylvania. Questions ..y be answered by ~allin8 (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 201004676
Date 04-05-2004
EstabUshed
To insure proper credit to your account, two
(2) copies of this notice .ust acc~pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
A.ount Subject to Tax
Tax Rate
Potential Tax Due
1,128.17
X 50.000
564.09
X .15
84.61
TAXPAYER RESPONSE
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
yOU .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. D The above infor.ation and tax due is correct.
1. You.ay choose to re.it pay.ent 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 assess.ent will be issued by the PA Depart.ent of Revenue.
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. D The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
4. Amount Subject to Tax
5. Debts and Deductions
6.
7.
8.
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
x
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
Amount Taxable
Tax Rate
6
7
8
x
Tax Due
PART
[!)
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
.
perjury, I declare that the facts I have reported above are true, correct and
.y knowledge and belief.
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