HomeMy WebLinkAbout09-10-07
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
INHERIT ANCE AND EST ATE TAX
OFFICIAL RECEIPT
NO. CD 008651
RECEIVED FROM:
PAINTER RODNEY W
680 CREEK ROAD
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
ESTATE INFORMATION: SSN: 195-32-4744
FILE NUMBER: 2107-0825
DECEDENT NAME: PAINTER DOROTHY
DATE OF PAYMENT: 09/10/2007
POSTMARK DATE: 09/10/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 06/14/2007
07137878
07137880
$349.30
$68.65
____-w__ fold
TOT AL AMOUNT PAID:
$417.95
REMARKS:
CHECK# 2982
INITIALS: CJ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
SEAL
REGISTER OF WILLS
COIIllItIfIEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 210681
HARRISBURG. PA 17128-0'01
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21"01-0~1<;
07137878
08-29-2007
!lEV'1S4I EX -JtJi lit-Iii
TYPE OF
ACCOUNT
lil SAVINGS
o CHECKING
o TRUST
o CERTIF.
1001 SEP 10
p,r\
9: 3 \ EST. OF DOROTHY PAINTER
5.5. BO. 195-32-4744
DATE OF DEATH 06-14-2007
coUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
r en" "~
0Lcril\ (,)-
ORPH!\N'S COum
C\J'Ir;'T\ .-' I'" .-,~, Ct:"
\',.:' ; "
TANYIA FORRESTER
97 VICTORY CHURCH RD
GARDNERS PA 17324
MEMBERS 1ST FCU has providad tha Dapa..t.ant ..ith the in1o....Uon listed b.lC1lf ..hich has b..n us.d in
ca1cul.ti... the poteatial tax .... Their receNIs indic.t. that .t the ....th of the ....... deceiMnt. y- ...ra a joint _r'......ficiarY of
tllis lICC-". If _ f_l this int_ti- is i.....rrect. pl_ _tain ..ritt... correcti- f..- the 11_181 1nstitut1.... attKll · -
t. this fo... ..... rat..... it to the ....... adIIt'"eSS. This _t is t.abl. in acco.......... ..ith the I......it....,. T. L_S of the ~.81th
of P.nnsYlvania. Qu.stions.ey b. .nsw....d bY celline (717) 787-8327.
COMPLETE PART 1 BELOW
. .
. SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date 09-14-1973
x
49,022.49
16.667
8, 17 0 .58
.045
367 . 68
TAXPAYER RESPONSE
To insu... p..oP." c...dit to you.. account. two
(2) copi.s of this notic. .ust acc~panf you..
pay..nt to the R.gist... of Wills. Mak. ch.ck
payable to. "R.gist.r of Wills. Ag.nt".
Account No. 15229-00
Established
Account Balance
Percent Taxable
A.ount Subject to Tax
Tax Rate
potential Tax Due
x
NOTE. If tax pey..nts .... ..d. ..ithin th....
(3) .onths of the d.c.d.nt's d.t. of d..th.
you .BY d.duct . 5X discount of the tax du..
AnY inh...it.ne. tax due ..ill b.c~. d.linqu.nt
nine (9) .onths aft... the d.t. of d.ath.
PART
ill
A. gTh. .bov. info...ation and tax due is co.....ct.
1. You.ay choos. to ....it pave.nt to the R.gist... of Wills ..ith two copi.s of this notic. to obtain
. discount 0" avoid int....st. 0" you .ey ch.ck box "A" and ...tu..n this notic. to the R.giste.. of
Wills and an official ass.ssa.nt ..ill b. issu.d bY the PA D.pa..t..nt of R.venue.
B. 0 Th. above ass.t has b..n 0" ..ill b. ...po..t.d and tax paid ..ith the P.nnsYlvania Inh...itanc. Tax ...tu..n
to b. fil.d bY the dec.d.nt's ...p..es.ntative.
C. 0 Th. above info...ation is inco.....ct andlo.. d.bts and deductions ...... paid bY you.
You .ust coapl.te PART 0 andlo" PART m be1C1lf.
[CHECK ]
ONE
BLOCK
ONLY
x
If you indicate a different tax rate. please state your
relationship to decedent:
PART
[!l
TAX RETURN - COMPUTATION
lIME 1. Date EstaDllsbed
2. Account Balance
3. Percent Taxable
4. A.ount subject to Tax
5. Debts and Deductions
6. A.ount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
DEBTS AND DEDUCTIONS CLAIMED
PART
[!l
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Ente.. on Line 5 of Tax Computation)
.
perjury. I declare that the facts I
.y knowledge and belief.
have reported above are true, correct and
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TELEPHONE NUMBER DATE
c
-
-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21- 07 -<1~?. <)
07137880
08-29-2007
1IEV-\~~3Ex OFP "9-DOl
20D1 SEP \ 0 Mil 9: 3 I
EST. OF DOROTHY PAINTER
S.S. NO. 195-32-4744
DATE OF DEATH 06-14-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
!Xl CERTlF.
TANYIA
97 VICTORY
GARDNERS
ClER\\ OF
ORPHAN'S Coum
CUrlfT-;j ~---, Fi\
FORRESTER
CHURCH RD
PA 17324
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1 ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate tilat at the death of the above decedent, you were a ioint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a c~py
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calli~g (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 15229-42
Date 01-25-2005
Established
To insure proper credit to your accountt two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
9,635.41
X 16.667
1,605.93
X .045
72.27
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
[!]
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. r=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. r=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
[CHECK ]
ONE
BLOCK
ONLY
LINE . DatE:! Cs tcluli:.:ihtd..i
. .
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 TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please state your
relationship to decedent:
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
$
perjury, I declare that the facts
my knowledge and belief.
have reported above are true, correct and
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TELEPHONE NUMBER
1