HomeMy WebLinkAbout10-30-07
COMMONWEAL TH 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 Ql QC11'1
07145890
10-25-2007
REY-1543 EX AF'P (09-00)
EST. OF ANNA K MARTINI
S.S. NO. 186-28-4088
DATE OF DEATH 08-26-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
o TRUST
[Xl CERTIF.
BEVERLY M NOLL
588 W AREBA AVE
HERSHEY PA 17033
REMIT P~~ENT AND FQ~MS TD:
REGISTER OP~:W:ULS
CUMBERLANDC(}'COURT 'BOUSE
CARLISLE, PA ").71113'
( .'-.)
(--:
PNC BANK has provided the Department with the information listed below which has~, been us8'<t-in
calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint owner)&eneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution,~tach a COpy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of~ Commonwealth
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. 31100224096
Date
Established
03-02-2005
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
x
8,213.75
50.000
4,106.88
.045
184.81
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.
x
PART
I!I
[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 Department of Revenue.
8. ~ 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.
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
[!I
DATE PAID PAYEE
OF TAX ON JOINT/TRUST ACCOUNTS
1
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:
DEBTS AND DEDUCTIONS CLAIMED
DESCR I PTI ON
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
*
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
HOME (
WORK (
TI=I I=PHONE
)
)
NUMBER
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
NOLL BEVERLY M
588 W AREBA AVENUE
HERSHEY, PA 17033
___.,un fold
ESTATE INFORMATION: SSN: 186-28-4088
FILE NUMBER: 2107-0979
DECEDENT NAME: MARTINI ANNA K
DATE OF PAYMENT: 10/30/2007
. .
POSTMARK DATE: 10/29/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 08/26/2007
NO. CD 008879
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $184.81
I
I
I
I
I
I r
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 892
- 'SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
'$184.81
GLENDA FARNER STHi'. SBAUGH,.
REGISTER OF WILLS.
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