HomeMy WebLinkAbout11-13-07
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
CRUTCHER KAREN
809 NESBIT DRIVE
CARLISLE, PA 17013
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ESTATE INFORMATION: SSN: 383-28-9592
FILE NUMBER: 2107-1038
DECEDENT NAME: MOODY CARL C
DATE OF PAYMENT: 11/13/2007
POSTMARK DATE: 11/13/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 08/27/2007
NO. CD 008959
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07144053 I $169.67
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I
I
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 41 08
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$169.67
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
07144053
10-18-2007
REY-1543 EX AFP COP-DO)
TYPE OF
ACCOUNT
D SAVINGS
liJ CHECKING
D TRUST
D CERTIF.
@
EST. OF CARL C MOODY
S.S. NO. 383-28-9592
DATE OF DEATH 08-27-2007
COUNTY CUMBERLAND
"'"- )
** KAREN CRUTCHER
809 NESBIT DR
CARLISLE PA 17013
(J--
REMIT PAYM~~ND FO~~ TO:
REGISTER OF W!~S
CUMBERLAND CO COURT HOGSE
CARLISLE, PA f~Or3
(.....)
MEMBERS 1ST FCU has provided the Department with the information listed below which has-been used in...-
calculating the potential tax due. Theil' records indicate that at the death of the above decedent, you were a joint owner/beO@1.)ciary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the ComMonwealth
of Pennsylvania. Questions may be answered by call1ng (717) 787-8327.
COMPLETE PART 1 BELOW * ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 308803-11
Date 06-27-2007
Established
To insure propel' credit to your account, two
(2) copies of this notice Must accompany YOUI'
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
7,937.72
X 50.000
3,968.86
X .045
178.60
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
yOU may deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
ill
[CHECK ]
ONE
BLOCK
ONLY
A. D 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.
B. D 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. D The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
TAX ON JOINT/TRUST ACCOUNTS
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
1
2
3
4
5
6
7
8
X
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation)
*
Under penalties of
complete to the best
Jt:~
declare that the facts I have reported above are true, correct and
and belief. HOME (7/7 ) ~ Y3- 7rJ.1S-
WORK (....---)
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")13J 07
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