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Home My WebLink About10-29-07 (2) 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. CO.008873 DUPLICA TE ANDERSON JACQUELIN 12045 GERALD AVENUE GRANADA HILLS, CA 91344 -------- fold ESTATE INFORMATION: SSN: 160-16-8651 FILE NUMBER: 2107-0552 DECEDENT NAME: W ALLOWER EVA DATE OF PAYMENT: 10/29/2007 '" POSTMARK DATE: 10/29/2007 COUNTY: CUMBERLAND DATE OF DEATH: 02/28/2007 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07119697 I $538.66 I , , ',- I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY CHECK#1043 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS $'538.66 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 HEV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ANDERSON JACQUELIN 12045 GERALD AVENUE GRANADA HILLS, CA 91344 ..___u"__ fold ESTATE INFORMATION: SSN: 1 60-1 6-8651 FILE NUMBER: 2107-0552 DECEDENT NAME: W ALLOWER EVA DATE OF PAYMENT: 10/29/2007 POSTMARK DATE: 10/29/2007 COUNTY: CUMBERLAND DATE OF DEATH: 02/28/2007 NO. CD 008873 ACN ASSESSMENT CONTROL NUMBER AMOUNT '1:@4 I $538.66 -'^ t5\:Ll9\o<1 I I I I I I , . I - I . TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTORNEY CHECK#1043 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS , '$538.66 GLENDA FARNER STRP.:SBAUGH..-, REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 *' FILE ACN DATE NO.21 ('), CJ6E':,~ 07119697 05-03-2007 INFORMATION NOTICE AND TAXPAYER RESPONSE REV-lSli3 EX AFP (09-00) EST. OF EVA WALLOWER S.S. NO. 160-16-8651 DATE OF DEATH 02-28-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [Xl SAVINGS o CHECKING o TRUST o CERTIF. REMIT PAYMENT AND F~S TO: REGISTER OF>-W~LS c~ CUMBERLAND ~~OURT ;H9USE- CARLISLE, PA""'"d;L(!13 n 'I---,.. -1 -""':..r- ~LE! (I'; ~); JACQUELIN ANDERSON 12045 GERALD AVE GRANADA HILLS CA 91344 N \.D -0 ::It MEMBERS 1 ST FCU has provided the Department with the information listed below which'M!lT'ieen used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a.jOfrit owner/1i.ineficiary ,of this account. If you feel this information is incorrect, please obtain written correction from the financial:$Astitution, ~ach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of ~Commonwealt~ of Penn~ylv~r.ia. Questions may be Gr.swered by callin& '717) 787~83274 Account No. 6050-05 COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] Date 03-15-2000 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". 75,639.98 X 16.667 12,606.92 X .045 567.31 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. 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 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 must complete PART ~ and/or PART ~ below. PART ~ TAX 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 RETURN - COMPUTATION OF TAX ON 1 2 3 4 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED [!] DATE PAID (fA""j~<,, PAYEE ~ /I."":',, t:U. " ~ r/L L DESCR I PH ON h)(. t1B VIe:... ~ r AMOUNT PAID to ~(,.t:.{g TOTAL (Enter on Line 5 of Tax Computation) $ 'rjury, I declare that the facts kno ledge and belief. DATE and HOME ( WORK ( TELEPHONE