HomeMy WebLinkAbout07-31-07
COMMONWEALTH OF PENNSYLVANIA,
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
R!;;C!;;IV!;;D I=ROM:
PENNSYLVANIA
INH~RITANC~ AND ~STAT~ TAX
OFFICIAL RECEIPT
BEA TY LINDA C
205 W MAIN STREET
SHIREMANSTOWN, PA 17011
-------- fold
ESTATE INFORMATION: SSN: 183-16-9805
FILE NUMBER: 2107-0643
DECEDENT NAME: MONTIJO FLORENCE S
DA TE OF PAYMENT: 07/31/2007
POSTMARK DATE: 07/30/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 05/03/2007
NO. CD 008474
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07127700 I $103.88
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: LINDA BEATY
CHECK# 3672
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
$103.88
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
?':C/.: : I;;P':":E:HOiESHpOOTHISCEE
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FILE
ACN
DATE
NO. 21- o'7-?B
07127700
06-20-2007
lINDA C BEATY
205 W MAIN ST
SHIREMANSTOWN
2001 JUL 3 \ PM \2: 50
TYPE OF ACCOUNT
[Xl SAVINGS
D CHECKING
D TRUST
D CERTIF.
EST. OF FLORENCE S MONTIJO
S.S. NO. 183-16-9805
DATE OF DEATH 05-03-2007
COUNTY CUMBERLAND
CLERK Of
QRPHlI,N'S CQl)RI
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REMIT PAYMENT AND FORMS TO:
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17011
PSECU has p..ovided the Depa..t.ent with the info...ation listed below which has been used in
calculating the potential tax due. Thei.. ..eco..ds indicate that at the death of the above decedent, you we..e a joint owne../beneficiar-y of
this account. If you feel this info...ation is inco....ect, please obtain w..itten co....ection f..o. the financial institution, attach a copy
to this fo... and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax Laws of the Co..onwealth
of P4nnsylvania. Questions .2Y be answe..ed by ~alling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0183169805
Date
Established
09-22-1999
To insu..e p..ope.. c..edit to you.. account, two
(2) copies of this notice .ust acco.pany you..
pay.ent to the Registe.. of Wills. Make check
payable to. "Registe.. of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
[!]
x
4,860.10
50.000
2,430.05
.045
~ lo3.8~
TAXPAYER RESPONSE
NOTE. If tax pay.ents a..e .ade within th..ee
(3) .onths of the decedent's date of death,
you .ay deduct a 5% discount of the tax due.
Any inhe..itance tax due will beco.e delinquent
nine (9) .onths afte.. the date of death.
x
A. c=J The above info...ation and tax due is co....ect.
1. You.ay choose to ..e.it pay.ent to the Registe.. 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 assessMent will be issued by the PA Depa..tment of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. c=J The above asset has been 0.. will be ..epo..ted and tax paid with the Pennsylvania Inhe..itance Tax ..etu..n
to be filed by the decedent's ..ep..esentative.
C. c=J The above info...ation is inco....ect and/o.. debts and deductions we..e paid by you.
You .ust co.plete PART ~ and/o.. PART ~ below.
If you indicate a diffe..ent tax rate, please state you..
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
[!]
TAX
LINE 1. Date Established
2. Account Balance
3. Pe..cent Taxable
4. Amount SUbject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
I!l
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
.
and
TOTAL (Enter on Line 5 of Tax Computation)
of pe..jury, I declare that the facts
o~knOWledge and belief.
!(~DI(9 fI5
have reported above are true, correct
(7/7) 7:37-72,07
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