HomeMy WebLinkAbout09-18-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
LUCY DEBORAH A
533 GOOD HOPE ROAD
MECHANICSBURG, PA 17050
----- --- fold
ACN
ASSESSMENT
CONTROL
NUMBER
07134258
ESTATE INFORMATION: SSN: 202-20-2047
FILE NUMBER: 2107-0852
DECEDENT NAME: KAUTZ JANET L
DATE OF PAYMENT: 09/18/2007
POSTMARK DATE: 09/17/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/26/2007
REMARKS:
CHECK# 531
SEAL
TOTAL AMOUNT PAID:
INITIALS: CAJ
RECEIVED BY:
REV-1162 EX(11-961
NO. CD 008702
AMOUNT
$66.06
$66.06
GLENDA FARNER STRASBAUGH .
REGISTER OF WILLS
REGISTER OF WILLS
..
COMMOIff/EALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 1712B-0601
*-n
rJ[N~O~~ATION NOTICE
"".1,- I" AND
..tAXPAYER RESPONSE
NO.
21 ,07 -o85c2
07134258
08-10-2007
FILE
ACN
DATE
R[V-1S45 EX IEP (D9-on
2001 SEP I 8 PrI 12: 45
EST. OF JANET L KAUTZ
CLE"::K OF 5.5. NO. 202-20-2047
Of"'\DIJ!,f.i,'C' .~r~, JRTDATE OF DEATH 02-26-2007
CU~,~...I'" !." \...",'.. II~OUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[i] CHECKING
o TRUST
o CERTIF.
LUCY A DEBORAH
124 WOODS DR LOT 9A
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
COMMERCE BANK has provided the Depart..nt with the info...ation listed below which has been used in
calculating the potential tax due. Theil' records indicate that at the death of the above decedent. you were a joint owner/beneficiary of
this account. If you feel this info...ation is incorrect. please obtain written correction fro. the financial institution. attach a copy
to this fo... and return it to the above address. 'This account is taxable in accordance with the Inheritance Tax Laws of the co..onwealth
of PennsYlvania. Ques~ions.ay be answarad bY calling (717) 7B7-B327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 536248750 Date 05-01-2003
Established
x
880.74
50.000
440.37
.15
66.06
TAXPAYER RESPONSE
To insure propel' credit to YOUI' account. two
(2) copies of this notice Must acco.pany YOUI'
pay.ent to the Register of Wills. Make chack
payable to. "Register of Wills. Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
NOTE. If tax pay.ents are .ade within three
(3) .onths of the decadent's date of death.
you .ay deduct a 5% discount of the tax due.
Any inheritance tax dua will beco.e delinquent
nine (9) .onths after the date of death.
PART
m
A. ~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 01' avoid interest. 01' you .ey 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.
[ C~~~K ]
BLOCK
ONLY
B. c=l The above asset has been 01' will be reported and tax paid with the PennsYlvania Inheritance Tax return
to be filed by the decedent's representative.
C. c=l The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
x
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate. please state your
relationship to decedent:
OF TAX ON JOINT/TRUST ACCOUNTS
LINE L !late Established
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
PART
[!]
DATE PAID PAYEE
x
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL {Enter on Line 5 of Tax Computation>
.
Under penalties
c<8:~
TAXPAYER SIGNATURE
of perjury. I declare that the facts I have reported above are true. correct and
of my knowledge and belief. HOME (\ 11) laC\ \ - ~1 ~S-
A. d...u.c-A WORK ( )
. - d'- TELEPHONE NUMBER
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