HomeMy WebLinkAbout10-22-07 (3)
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
MURRAY BERNARD J TIT
15 FARM HOUSE LN ---'--
CAMP HILL, PA 17011
-------- fold
, -
ESTATE INFORMATION: SSN: 163-16-1090
FILE NUMBER: 2107-0610
~_..~
')f:::C:EDENT NAME: MURRAY M W
I CinE OF PAYMENT: lO/22/2007
: ".
~_.
i 10/22/2007
POSTMARK DATE:
COUNTY: CUMBERLAND
DATE OF DEATH: 01/22/2007
NO. CD 008836
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07123155 I $173.86
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TOTAL AMOUNT PAID:
REMARKS:
~ ":.,...
..' CHECK# 2555
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INITIALS: JA
RECEIVED BY:
SEAL
l>_
REGISTER OF WILLS
;.,....
'$173.86
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 C>., <., 10
07123155
05-31-2007
REV- ~S43.EX AFP (09- DO)
ODCI! It !.\
It! r ,....,
('I 'ff--
BERNARD J MURRAY ~
15 FARM HOUSE LN
CAMP HILL PA 17011
Or.'l" '),) '" '" 1.3
~ '-'- i'.h 'j: ,+
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
[i] TRUST
D CERTIF.
EST. OF M W MURRAY
S.S. NO. 163-16-1090
DATE OF DEATH 01-22-2007
COUNTY CUMBERLAND
REMIT PAYMENT AND FDRMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
COMMERCE BANK has provided the Department with the infor.ation 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 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. Questions .ay be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 512099649
Date 09-07-2006
Established
To insure proper credit to your accountt two
(2) copies of this notice .ust acco.pany 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
ill
3,863.59
X 100.00
3,863.59
X .045
173.86
TAXPAYER RESPONSE
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
you .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
A. c:J 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 or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
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 .ust co.plete PART ~ and/or PART ~ below.
OF TAX ON JOINT/TRUST ACCOUNTS
I
2
3 X
4
5
6
7 X
8
PART
[!J
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please state your
relationship to decedent:
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
.
TOTAL (Enter on Line 5 of Tax Computation)
HOME
perjury, I declare that the facts I
my. nowledge and belief.
correct and
fZJ~
have reported above are true,
(7/7) 7'37
WORK ( )
TELEPHONE NUMBER
DATE