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Home My WebLink About09-12-07 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 HEYMAN EUGENE F JR 619 lEREW DR BOILING SPRINGS, PA 17007 --~---~- fold EST A TE INFORMATION: SSN: 100-01-9598 FILE NUMBER: 2107-0832 DECEDENT NAME: HEYMAN ELSIE A DATE OF PAYMENT: 09/12/2007 POSTMARK DATE: 09/10/2007 COUNTY: CUMBERLAND DATE OF DEATH: 06/23/2007 NO. CD 008664 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07137876 I $83.41 I I I I I I ; I I TOTAL AMOUNT PAID: 'REMARKS: EUGENE HEYMAN JR CHECK#1023 SEAL INITIALS: DM RECEIVED BY: REGISTER OF WILLS $83.41 GLENDA FARNER STRASBAUGH . REGISTER OF WillS C1 q~:K ."') f: Lei I. ,\.. ORPH.~\r.j'S COtJRT elll (r"''"'. Dt\ _J l\i. . : .."'-\ EUGENE F HEYMAN 619 LEREW RD BOILING SPGS PA 17007 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVI.9.l,I~~. ~~s ,_..'- DEPT. 280601 ...,:... . HARRISBURG, PA 17128-.!I~0l. 20U1 SEP I 2 At) \0: 48 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 - Ql-l>~^ ACN 07137876 DATE 08-29-2007 REV-15411 EX AFP <09- 00> EST. OF ELSIE A HEYMAN S.S. NO. 100-01-9598 DATE OF DEATH 06-23-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. 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 inforllation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this inforMation is incorrect, please obtain written correction frOM the financial institution, attach a COpy to this forM and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COllllonwealth of Pennsylvania. Questions May be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 210206-11 Date 10-12-2001 Established To insure proper credit to your account, two (2) copies of this notice must accompany your pay.ent 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 PART [!] 3,707.04 X 50.000 1,853.52 X .045 83.41 TAXPAYER RESPONSE NOTE: If tax paYMents are .ade within three (3) Months of the decedent's date of death, YOU lIay deduct a 5% discount of the tax due. Any inheritance tax due will becolle delinquent nine (9) months after the date of death. 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 assessllent will be issued by the PA DepartMent of Revenue. [CHECK ] ONE BLOCK ONLY B. c=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. c=J The above inforMation is incorrect and/or debts and deductions were paid by you. You Must COMPlete PART 0 and/or PART ~ below. 1 2 3 X 4 5 6 7 X 8 If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1- Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!] DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID .1 . and TOTAL (Enter on Line 5 of Tax Computation) Under penalties comp~ to the TAXPAYER that the facts belief. have reported HOME ( ( WORK ( TELEPHONE '"ifjr,] \:- ", LUfJ vt~.,I 12 ~H 10: 48 1-"" .....\ o ..... .:..\ ...... (.) t....' (.) > ..... r - - ::'" - -:::-- : - '::"" - :::- - :- - ':'" :r .. - - :- - =- - - - ~~ 1~ ~ ~ ~~ ~~B -... jI ~ "l ~ ......j ~ -- ~ ~~~ _.~~ -EI f' 1~ - - ~ ~ - ~ Q ~ -.,) 'ti, Ui ~~~ .\i ;~, ~. ~l ~! tb ~. .f'" ~~ ~. ;~;, ~~ :~~ F o .~ '?} ":'l::'~ '~f.~ ~!~~~, \'t.~, yi '~~'I,), \u)' (Ill (, U{~: 'i_ ' ~r, \ \~. ~, t. 'l' '. ;', \ole \- '" 'jt; .\ ".,' ... ,