HomeMy WebLinkAbout06-18-07 (4)
~, ..J
~, 1"
~,
4 ~
~o.. 0..
\!) r..
f:t ~
" N
iJi ,. Z
l:"'" ~
~ n
i' ~
~
.
")
..
.
~
-:~
'\
-=
t
~
I
I,
~
\
1":" \ p\
J"" l""
1,~' . ~
, " \ \' t \}
L,i \ . ,
i~~
.~~~
\1'\ ~ ~
~~
Q
~
:c>
\
~
-t-'
o
~-d'8
.~,?; t;:.
~. co <
e~o..
,0; I,) .
.... .... oil
'7=>._.u. ~
6~.P-
o /J) ~
''0, co ....!
p..r
....
~.~ ~"
-
,
~
tf:i';
,-'
-;
...-.;:
...-.;:
...
.-
....::.
-:::
-:::
-
-:::
...
-:::
-:::
-
-:::
...
~
...;:.
-=
~
...
..:::.
-:::
...
...
::::.
-:::
::.
-
i(\
(:.\
--,..,
\.
(....
........
",lO,
\ .
.....
."
t.~
r"
.....
COMMONWEALTH 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 Of 5'8'S
07125539
06-08-2007
REY~ 15liS EX AFP (at~OD)
TYPE OF ACCOUNT
7
I
d 18
~T4loF EDMUND J KALBFLEISCH
S.S. NO. 069-14-3891
DATE OF DEATH 07-23-2006
.qpUNTY CUMBERLAND
[i] SAVINGS
o CHECKING
o TRUST
o CERTIF.
r" i-.r~1/
Iv Lt~..:.iI\ '
On-.),/,;
;""/,..'-'-'
II, "
eLf/' ....
EVELYN C KALBFLEISCH
1214 BENT CREEK BLVD
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SOVEREIGN BANK has p..ovided the Depa..hent with the info...ation lishd below which has been used in
calculatinv the pot.ntial tax du.. Th.i.. ...co..ds indicat. that at the d.ath of the above deced.nt, you w...e a ioint own.../b.n.ficial'Y of
this account. If you f..l this info...ation is incor..ect, please obtain w..itten co....ection f..o. the financial institution, attach a cOPY
to this fo... and ...tu..n it to the abov. addr.ss. This account is taxable in acco..dance with the Inhe..itance Tax Laws of the Co..onw.alth
of P.nnsylvania. Questions .ay b. answe..ed by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0774047047
Date
Established
08-27-2002
To insu..e p..opa.. c..edit to your account, two
(2) copies of this notice .ust acco.pany you..
pay.ent to the Registe.. of Wills. Make check
payable to I "Registe.. of Wills. Ag.nt".
Account Balance
Percent Taxable
Amount SUbject to Tax
Tax Rate
Potential Tax Due
x
13,577.57
16.667
2,262.97
.15
339.45
TAXPAYER RESPONSE
NOTE. If tax pay.ants a..e .ade within th....
(3) .onths of the decedent's data of death,
you .ay deduct a 5% discount of the tax due.
Any inh...itance tax due will b.co.e delinquent
nine (9) .onths aft... the data of death.
x
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. r=J The above info...ation and tax due is co....ect.
1. You.ay choose to ..e.it pay..nt to the Regist... of Wills with two copies of this notice to obtain
a discount 0" avoid inte..est, 0.. you .ay check box "A" and ..etu..n this notice to the Registe.. of
Wills and an official assess.ent will be issued by the PA Depa..t..nt of Rev.nue.
B. r=J Th. above asset has b.en 0.. will b. ..epo..ted and tax paid with the PennsYlvania Inh...itance Tax ...tu..n
to be filed by the decedent's ..ep..esentative.
C. ~Th. above info...ation is inco.....ct and/o.. d.bts and d.ductions we... paid by you.
)ll'You .ust co.plete PART ~ and/o.. PART ~ below.
PART If you indicate a different tax ratef please state your
~ relationship to decedent: T1l11 l8A::tt:r
TAX RETURN - COMPUTATION OF TA ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 - 2. - O"l.
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
5. Debts and Deductions 5
:: ~::"::::...... : X ;J: f1l
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
.
perju"y, I declare that the facts
my knowladge and belief.
have reported
correct and
(
v-..
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
KALBFLEISCH EVELYN C
1214 BENT CREEK BLVD
MECHANICSBURG, PA 17055
-------- fold
ESTATE INFORMATION: SSN: 069-14-3891
FILE NUMBER: 2107-0585
DECEDENT NAME: KALBFLEISCH EDMUND J
DATE OF PAYMENT: 06/18/2007
POSTMARK DATE: 06/16/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 07/23/2006
NO. CD 008299
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07125539 I $101.83
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$101.83
REMARKS:
CHECK#109
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS