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Home My WebLink About10-30-07 (2) H ;.'" i".. f-l ~ ;.:( ~ ~ !i u.. ~ r-, t;" rtf;; ~ ~i ;J'J j,.. it u ti 0 ( -"r.,,' J: [:.1. ," - f fi ,h ~f"ll :g <t:'~ ~lkj ;:: <t: ~.J ~,:;;. ;;0., Q];;> 0, ca, 7,1, < ~ E3 'I ,,>n ::C' ~> \ 'I \-.u ~ ~ \n~ ''-.) ~ -J::j~ ..... ""J ........ ~~~ . .......... \+ 8~ \) ~ ~ ~ ~' ':-(J ~ \~ K ----J "-..J '2 ~j '0" ~ ~ IN.J f 'S::t ~":)'-J '0 'c/mJ jtJO ,., n'07 0., .7!.'J C r: " "J' 'J (, .. t.l , - - ~ - - - ~ - - - - - .- - - - - - - ,- ,".l In I:') f') ..... ,.,', :,.:, .... I.. I'" .r. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 D""l '1l~ 07145891 10-25-2007 REY-1543 EX AFP(09~OD) - -I r...), ;,-'J i, 'I ,0;. ? I .. l.. i" ( '-.... "'" TYPE OF ACCOUNT D SAVINGS [i] CHECKING D TRUST D CERTIF. EST. OF ANNA K MARTINI S.S. NO. 186-28-4088 DATE OF DEATH 08-26-2007 COUNTY CUMBERLAND BEVERLY M NOLL 588 W AREBA AVE HERSHEY PA 17033 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PNC BANK has provided the Department with the inforllation 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/beneficiary of this account. If you feel this inforllation is incorrect. please obtain written correction from the financial institution, attach a copy to this forll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COII.onwealth of Pennsylvania. Questions lIay be answered by calling (717) 787-B327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5005482515 Date 03-02-2005 Established To insure propel" credit to your account, two (2) copies of this notice must accollpany your paYllent 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 PART [!] 1,200.08 X 50.000 600.04 X .045 27.00 TAXPAYER RESPONSE NOTE. If tax payments are .ade within three (3) 1I0nths of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will becolle delinquent nine (9) months after the date of death. A. [] The above inforllation and tax due is correct. 1. You lIay choose to rellit payllent to the Register of Wills with two copies of this notice to obtain a discount 01" avoid interest, 01" you lIay 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 01" will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative4 C. [] The above inforllation is incorrect and/or debts and deductions were paid by you. You IIUSt COMPlete PART ~ and/or PART ~ below. 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: 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 PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION 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. TAXPAYER SIGNATURE HOME ( WORK ( TELEPHONE ) ) NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV- i 162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NOLL BEVERLY M 588 W AREBA AVENUE HERSHEY, PA 17033 --~-..._- 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. Cq,qp8882 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07145891 I $27.00 I i' I I I I I ....! I I TOTAL AMOUNT PAID: REMARKS: CHECK# 893 'SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS '$27.00 GLENDA FARNER STR-ASBAUGH REGISTER OF WILLS-