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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 HOME (.,n ) ~~-~L(Dl1 WORK ( ) 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 HOME ( '1 n ) l.\. ~- ~4tJi WORK ( ) TELEPHONE NUMBER 1