HomeMy WebLinkAbout11-14-07
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. CD 008970
SCHWEITZER JULIE M
8 MARY AVENUE
MECHANICSBURG, PA 17055
-------- fokf
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07002496
$1,309.08
ESTATE INFORMATION: SSN: 211-22-6547
FILE NUMBER: 2106-0954
DECEDENT NAME: WOODS SAMUEL JR
DATE OF PAYMENT: 11/14/2007
POSTMARK DATE: 11/10/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 10/21/2006
TOTAL AMOUNT PAID:
$1,309.08
REMARKS:
CHECK# 5976
SEAL
INITIALS: CJ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
, !
ROBERT C. SCHWEITZER
JULIE M. SCHWEITZER
8 MARY AVE.
MECHANICSBURG. PA 17055
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280tiOl
HARRISBURG, PA 17128-0tiOI
*' INFORMATION NOTICE
r- f'\ ,.,- AND
10 . 0 rlCE ltAXPAYER RESPONSE
REVfiOOa;r.Gl \"LL~EVISED NOTICE * * *
FILE
ACN
DATE
NO.21 06-0954
07002496
10-22-2007
JULIE SCHWEITZER
8 MARY AVENUE
MECHANICSBURG
a.ERK OF
ORflt-L6N'S COURT
ClJM8ERLAND CO... PA
P" 1= 31 EST. OF SAMUel WOODS
5.5. NO. 211-22-6547
DATE OF DEATH 10-21-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[i] SAVINGS
o CHECK I NG
o TRUST
o CERTIF.
Z001 NOY 14
PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
INTEGRITY BANK has provided the Departaent with the info...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 inforaation is incorrect, please obtain written correction froa 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 Coaaonwealth
of PennSVlvania. Questions ..Y be answered by callin~ Cl17} 787-8321.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0401003989
Date
Established
01-10-2000
To insure proper credit to your account, two
C2} copies of this notice aust accoapany YOUI'
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
17,454.37
50.000
8,727.19
.15
1,309.08
NOTE. If tax payaents are aade within three
C3} 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 date of death.
x
PART
[!J
A. &r!he above inforaation and tax due is Correct.
I. You aBy choose to reait 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
If YOU indicate a different tax rate, please state YOUI'
relationship to decedent:
B. c=J 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=J The above inforaation is incorrect and/or debts and deductions were paid by you.
You aust coaplete PART ~ and/or PART ~ below.
PART
[!J
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
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF TAX ON JOINT/TRUST ACCOUNTS
I
2
3
4
5
x
6
7
8
x
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
.
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RECORDED OFFICE OF
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2001 HOY 14 PM I: 31
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