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Home My WebLink About11-09-07 REV-1162 EX( 11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 008937 RECEIVED FROM: WELSH JOSEPH M SR 27 SALT ROAD ENOLA, PA 17025 ACN ASSESSMENT CONTROL NUMBER AMOUNT ---.---- fold 07146563 $17.37 ESTATE INFORMATION: SSN: 187-16-2154 FILE NUMBER: 2107-1022 DECEDENT NAME: WELSH DOLORES E DATE OF PAYMENT: 11/09/2007 POSTMARK DATE: 11/06/2007 COUNTY: CUMBERLAND DATE OF DEATH: 09/26/2007 TOTAL AMOUNT PAID: $17.37 REMARKS: CHECK# 285 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 17128-0601 ... INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-01.102..2- 07146563 11-02-2007 llE'4-j541Ii)C IE' (0'.'0) 1 t'r" .., '7G(i> 1" -l..l {~I.3 i '".I "; -' F'I'I \2: 20 EST. OF DOLORES E WELSH S.S. NO. 187-16-2154 DATE OF DEATH 09-26-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS iii CHECKING o TRUST o CERTIF. elF O~r-"I" Irl;"'I-\:'-~': C' F"" -- Ui"i REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 JOSEPH M WELSJ SR 27 SALT RD ENOLA PA 17025 COMMUNITY BANKS has provided the Departnnt 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 infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a COpy to this fOrN and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of ~enn5ylvania. Questions.ay be answerea by calling (717) 787-D~~7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5677886909 Date Established 08-09-2005 To insure proper credit to your account, 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". x 772.08 50.000 386.04 .045 17.37 TAXPAYER RESPONSE NOTE. If tax pay.ents are .ade within three (3) .onths of the decedent's date of death, you .ay deduct a 5X discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x PART [!] E~"':""l:1TtYJiEGl}-:=-r-1"'t-;'Y;~':H;';E'W";:-1~~I1'1':~~1JIf.rfl];:-r'f1:?:n:-ir~'!F:li'a,~,,::'c"~'fji!Hl;:!l!iH;-U;:i\lr1't.t::j;:-'~~-<:'~""""'L"t:c.:'f-ltx':H;~r-m~Y~1fl-WCi'f"l'~-:W;:;f:l """''!J:""..J.~.--~ !l!;','l,.".~""~",,o:.~..<i:{'~ _.__",""~,~' _{_~'"'" ",~,~""~"".".._.",,,"~."-.~ 3t.w,),-ir:!:- . "jl'''~k-l:... ~~c..!li;'ll f'__-'"rnr..~.~"k,"~-~"," . ~ :!. ~ !!il'!~""____~""~,,,,,,",,,.'la\!','.c~Jj;..:!'; k. ':4~ ~h.f'..-....,.:.:h.~.r_:.t-.. iW..:t::..-__~-:Hb-!}_-_,,'U"_~..'V'.:';:lah.'ti:'t.~_,.;:.:--- :r_*J ~"tet'_'t..,.'l.ht'........'!lW~..._~:r_-..:-Ji :r_'t.-;mt.tW,d'{;-- .."1.rt.1:-_'1-'t.-J'-:.t-.r":I-..r-'t.~~-!E. -_'11h-,f'_-..:-.."wr.l.:v-_-_'1- :.r~1f.ffii.Wi..>t.....n:1f.?'-~-'1--..t'~~~l1"..-- :tf:r. n:..~..tl:W A. 0 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 .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. [CHECK ] ONE BLOCK ONLY B. 0 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. 0 The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust co.plete PART ~ and/or PART [!] below. x If you indicate a different tax rate, please state your relationship to decedent: PART [!] TAX RETURN - COMPUTATION 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 OF TAX ON JOINT/TRUST ACCOUNTS 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) . that the facts I have reported above are true, correct and and belief. HOME I t/o J/o' . 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. 21-01-101.,1- 07146563 11-02-2007 REV.1541 EX AFP (09-00> Ok')'" b [,,-, I i: t......,,1 \1 ~ ":: Ci 1\ ),~.. , PH 12: 20 EST. OF DOLORES E WELSH ro,r.= 5.5. NO. 187-16-2154 >:'~iqT DATE OF DEATH 09-26-2007 ',,~:"\)l "\~~OUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS Ii] CHECKING o TRUST o CERTIF. 7c:rrl ~:TI - 9 .~ ,...u III ,_ . JOSEPH M WELSJ SR 27 SALT RD ENOLA PA 17025 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 COMMUNITY BANKS has provided the Departaent with the inforaation listed below which has been used in calculating the potential tax dua. Their records indicate that at the death of the above decedent. you were a ioint owner/beneficiary of this account. If you feel this inforaation is incorrect. please obtain written correction froa the financial institution. attach a COpy to this fora and return it to the above addrass. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth of PennsYlvania. Questions aay be answared by calling (7171787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5677886909 Date 08-09-2005 Established x 772.08 50.000 386.04 .045 17.37 TAXPAYER RESPONSE To insure proper credit to your account. two (2) copies of this notice aust accoapanv your payaent 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 NOTE. If tax payaents are aade within three (3) aonths of the decedent's date of death. you aay deduct a 5% discount of the tax due. Any inheritance tax due will becoae delinquent nine (9) aonths after the dete of death. PART ill _'T~~--0'~1"'~Y-'f~~:;;'f::Z-~--~:~--s-3'""::11E~"T~['fi~_~"'lyt~"::~:f":;f'Sf<:!I=~--'{HJ-:1,;:r:IIm:~~-:r~i-~:!jjf:Oi:t'1:?'~"Yfoqwfffji'fili.iWw"":!j:-a-'i!;:O{:~:;'r::;;?~iI *",,,,-~~~-~---o ___ ---1w"'x--"=-~--~ t', ___ ~ ~-U ~__" '---~-"''!,''"''w,r,,; x~~." __."c ~",,,""C""';c.'~~,,, !I'.}~~", ."",;,,-....-.-:h...._w.""."."',.:;;..rn-k"";h.~~+..H~~.- '" '~kJgr~_o;;,."',"';,.'hn.~.;:rOi:-U m::n.~-::-~-~-:r:1-.""-:w~..:--:{H:r:HHr_.,.,"::""1:".:r_..~....:-:-_-::;:-_..:~:-1:-M:..~..rfr'_~.r:'fr-:t:1hn:;:-.r.:-:-:!ti:~:f..~~~ ;:'~""l.'m 'i:-:r:-tm: _-iHr-;mjh.-~lmn.:..~:li;'t.-4:- tllii.l';::t'~~4: ~;>>.~1P1i.'i.f.P,.i-_"J1l.rn:;tt.'t.-u:~_-:.g..r~.,.-.r..nr.r.M.rM'1.i<-~i:r.n:-t:~::l'--t: ..Uit;.~1l"~-:::-r.!.r:..'ffiffil;f:'~ A. c=l The above inforaation and tax due is correct. 1. You aay choose to r..it payaent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest. or you aay check box "A" and return this notice to the Register of Wills and an official assessaent will be issued by the PA Departaent of Revenue. [CHECK ] ONE BLOCK ONLY B. c=l 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. c=l The above inforaation is incorrect endlor debts and deductions were paid by you. You aust coaplete PART ~ andlor PART [!] below. LINE l. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Allount Taxable 7. Tax Rate 8. Tax Due PART !!l DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate. please state your relationship to decedent: DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax COIlPutation) . Under penalties of perjury, I declare o the best of my knowledge and !.t ~A TAXPAY ATURE that the facts I have reported above are true. correct lief. (;;7 ) 732- ~'t"~ WORK (r7 ) ~~S--~3 . TELEPHONE NUMBER HOME and J4~/ TE 2C.:r!.] '",,',,'/ -q pn /2= 20 ~ IL. I _ . '.LI:" l ... OR?H/J!" R' l.~ C' I;" . , M lv, .' I i ~ ~ .~ .roff'J .~ ~ :J I,; iii ~ ~ :I: wen ::>>w z><z i w;!o 0 >..J(ij ..J.. w__ IlU a:-> N u..::>>S 1: os:! 'P'" ~~~'P"'~ w~woCJ -~ i!~o!a: a:oz:Si !C::>>;!><en ~;ffii~ ::>>::J:oc ~m~D..::J: I. \ T t .~ :i j. O. ~ -. ~ .' ~ - - - - " >1,-, _