HomeMy WebLinkAbout09-27-07
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
NO. CD 008750
GILBERT BARBARA JANE
1400 BENT CREEK BOULEVARD
APARTMENT 208
MECHANICSBURG, PA 17055
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
n______ fold
07102137
$176.06
ESTATE INFORMATION: SSN: 193-36-4179
FILE NUMBER: 2106-0715
DECEDENT NAME: BROWN JUDITH LOUISE
DATE OF PAYMENT: 09/27/2007
POSTMARK DATE: 09/26/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 07/31/2006
TOTAL AMOUNT PAID:
$176.06
REMARKS:
CHECK#1026
SEAL
INITIALS: CJ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 1712B-0601
*':E
, . ~ i ;l~
REV-ls.a EX OFP cdf."!
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REVISED NOTICE * * *
FILE
ACN
DATE
NO. 21 06 - 0715
07102137
09-19-2007
Sr~P 21 MilO:
EST. OF JUDITH L BROWN
S.S. NO. 193-36-4179
DATE OF DEATH 07-31-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[i] SAVINGS
D CHECKING
D TRUST
D CERTIF.
CLERr( C :
-':~)DU^".I,IS' n,(
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REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MARGUERIT S CRULL
1400 BENT CRK BLVD 208
MECHANICSBURG PA 17050
SOVEREIGN BANK has provided the DepartMent with the inforMation 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 obt.ain written ccrrection froM the financial institution. attach a copy
to thi.s fo,... l!\ntl return it to tt-t;\ -above address~ This account i~ taxabl~ in 3ccor:!ance with the liohari"tance Tax law:s of the Cuidiololltt"elth
of Pennsylvania. Questions May be answered by calling (717) 7B7-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1684002957
Date 03-05-1996
Established
To insure proper credit to your account. 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
2,347.49
X 50.000
1,173.75
X .15
176.06
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
[!]
[CHECK ]
ONE
BLOCK
ONLY
A. r.ll 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. [] 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. [] The above inforMation is incorrect and/or debts and deductions were paid by you.
You Must COMPlete PART ~ and/or PART ~ below.
X
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX
LINE 1.
2.
3.
4.
5.
6.
7.
8.
RETURN - COMPUTATION
TAX ON JOINT/TRUST ACCOUNTS
Date Established
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Amount Taxable
Tax Rate
Tax Due
OF
1
2
3
4
5
6
7
8
X
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
$
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TELEPHONE NUMBER
correct and .,
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DATE
perjury, I declare that the facts
m knowledge and belief.
have reported above are true,
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