HomeMy WebLinkAbout06-05-07 (2)
"t
I 'i
J
fI)
~
~
~
~ l")
0- ~
:r '" -
V) ~ J, (;:)
- }.: ~
C) ....
~ ~ .......
~
I ~~~
'Cl
I
- <:l
<'\ ~ ~
l~ .:i -J! '\
'" ~ It)
- ~
~ ~ ~
~~
'v
",'
flAt"- 8'
-...,."" 0
; .J.
~, (\I
if)> .'
..... .,'Z
~, "')
(i' .~
1('. ""'1
to ~
J
~
,<l
, .
ii'
"",
,
I~:.j
.
~
,
:.
,
i
.
'11
,''-'''.
,\ k'
\:\'jO
VI
VI
o
r-
I
)
~
~
~ "
~ "t:l CD
'<<l~ ....
,,~ 'l) .E
-- '"
Cl] o~
1::';:: ~
~.ao ..c::
,.O_u
o r- ~
.o:::.....~
\ \. : \ uJ
'\~'\
'" . .' ~
s- hi<
J'J\jj\) u----
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG. PA 17128-0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 0\ OS4q
07123139
05-31-2007
REV.1543 a MP,clt-en
j;~,;~j -:)
F ii I:
TYPE
! ~ST. OF VIVIAN EICHELBERGER
S.S. NO. 192-30-1569
DATE OF DEATH 04-12-2007
COUNTY CUMBERLAND
OF ACCOUNT
IiJ SAVINGS
o CHECK I NG
o TRUST
o CERTIF.
0'-'..-'
i I
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~.
ROBERT D PEARCE ~
171 BRINDLE RD
MECHANICSBURG PA 17055
MEMBERS 1ST FCU has providlld the o.part..nt with the infol'llation lishd balow which has baan 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 infor.ation is incorrect. please obtain written correction fro. 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 Co..onwealth
of PennSYlvania. Que.tions ~ be ans~.,..d by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 210596- 05
II II
II SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date
Established
10-24-2001
To insure proper credit to your account. two
(2) copies of this notice .ust acco.pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills. Agent".
x
66,008.43
50.000
33,004.22
.045
1,485.19
TAXPAYER RESPONSE
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death.
you .ay deduct a 5X discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
PART
[!]
[ C~~~K ]
BLOCK
ONLY
A. c:J 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. ~he above infol'llation is incorrect and/or debts and deductions were paid by you.
~~ou .ust co.plete PART ~ and/or PART ~ below.
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
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
10- .2L1- ZDD I
lob J D 0 s. LI '3
/;0 . 00 0
33.D'D'I..2.-z..
~' 5'-f~. If go
~ C! 454 _ .:3~
.oq.e:;
J:3 ;2~. '+Lf
DEBTS AND DEDUCTIONS CLAIMED
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
DATE
5 of Tax Computation)
PAYEE
DESCRIPTION
AMOUNT
.
rjury, I declare that the facts I
y knowledge and belief.
have reported above are true. correct and
HOME <?f")) b ~ /'!7'l/ V'
.
WORK ( )
TELEPHONE NUMBER 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
PEARCE ROBERT D
171 BRINDLE RD
MECHANICSBURG, PA 17055
--..---- fold
ESTATE INFORMATION: SSN: 192-30-1569
FILE NUMBER: 2107-0549
DECEDENT NAME: EICHELBERGER VIVIAN
DATE OF PAYMENT: 06/05/2007
POSTMARK DATE: 06/04/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 04/12/2007
NO. CD 008240
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07123139 I $1,259.17
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK#1095
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$1,259.17
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS