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Home My WebLink About10-03-07 "l' ';. \". \. ~ t-r~1 '1l ~ J'JI .t'S'~FliT~Afr~VER . ., ~ ::". ~ '. l "} f. . I ' .... t ~ _ \, \ \ I.) )) I( - \\ 'Pi !~ f~;. ,-'Ii ~ .... :t ""- t'" il.. '""" (:J r~~ tt ~~~ ~ 'fit c.,J i~ tJj ~7 : "~ ~ I.... y; ;)J tt il; e--.of !e>! '"l.. ;t '~ - ~ ~ I I o lr\ o ~ ~ ~ -.. .~ f::l t') E ~ i"; ':: ~ .~ ~ ~ ~ ~~~ ~ ~ ,~ "" "l ::: ~ ~ ~ " <Ii ~ U) o ~ >< UJ 0) ;! w wen :)W Z><Z ,... W;:!O ~ >-1cn 9 w<t_ co er:)~ ~ LLOO ...... 0>>< .,.. t- 0- ~Q. '5( Z ~.,.. w~w~~ ~LL()oer erOzre:) f~~><~ wWffiger oer:r er f~~~~ OJ "0 o U Q N lJ o ~ b' ~ c: o :;:; c: 2 ~ ('- .-, r ) ; COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0102 07113369 03-28-2007 REV-lS43 EX AFP (09.00) 'f U. - J E$'r , j'.&.F;-- f.. P L EHR S.S.'-NO':u 207-07-9275 DATE OF DEATH 12-03-2006 CO: COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS D CHECKING D TRUST D CERTIF. SHIRLEY A SMITH 1213 MITCHELL DR MECHANICSBURG PA 17055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BELCO COMMUNITY CU has pl'ovided the Depal'tment with the infol'mation 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 Commonwealth of Pennsylvania. Questions mav he answe~~rl hy ~~11ing (717) 7~7-83?7 COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 718490 Date 11-08-1993 Established To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Registel' of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Pel'cent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 2,392.53 X 50.000 1,196.27 X .045 53.83 TAXPAYER RESPONSE NOTE: If tax payments al'e made within thl'ee (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 aftel' the date of death. PART [!] [CHECK ] ONE BLOCK ONLY 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 Depal'tment of Revenue. B. [] The above asset has been 01' will be I'epol'ted and tax paid with the Pennsylvania Inhel'itance Tax I'etul'n 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/ol' PART ~ below. X PART ~ TAX If you indicate a diffel'ent tax I'ate, please state youI' I'elationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 2. Account Balance 2 3. Pel'cent 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 (Entel' on Line 5 of Tax Computation) $ Undel' penalties of pel'jul'Y, declal'e that the facts complete to the best of my knowledge and belief. y/A.iA.~.6 J L tl ~2L TAXPAYER SI~NATURE~ have I'epol'ted above al'e tl'ue, cOl'I'ect HOME ( 7/7) (pQ7 - 3g'13 WORK ( ) TELEPHONE NUMBER and 9-/-01 DATE 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 SMITH SHIRLEY A 1213 MITCHELL DRIVE MECHANCISBURG, PA 17050 __+_un fold --- ESTATE INFORMATION: SSN: 207-07-9275 FILE NUMBER: 2107-0102 DECEDENT NAME: LEHR FANNNIE PAULINE DATE OF PAYMENT: 10/03/2007 POSTMARK DATE: 09/12/2007 COUNTY: CUMBERLAND DATE OF DEATH: 12/03/2006 NO. CD 008776 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07113369 I ~53.83 I I I I I I I I TOTAL AMOUNT PAID: $53.83 REMARKS: CHECK#1063 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS