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Home My WebLink About11-08-07 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EXI11-96} RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 008929 DUPLICA TE SHAFFER BARBARA 60 WESTWOOD CT ENOLA, PA 17025 -------- fold ESTATE INFORMATION: SSN: 160-16-2902 FILE NUMBER: 2107-0938 DECEDENT NAME: PERRY VERNA V DATE OF PAYMENT: 11/08/2007 POSTMARK DATE: 10/16/2007 COUNTY: CUMBERLAND DATE OF DEATH: 08/02/2007 ACN ASSESSMENT CONTROL NUMBER AMOUNT 07140074 I $10.90 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: BARBARA SHAFFER CHECK# 4894 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS $ 1 0.90 GLENDA FARNER STRASBAUGH REGISTER OF WILLS . '\. "'" \ ';, '\)\"~;\ , i , 1. I' f I:-JI ' , ! I, II! r 1 . '. f' ... ... .z t ,. ! ~ \ \~., ~ 1 'i ~ \\\ ,\ \. 'l. ,... ' ,.-1 .?--~ a""O\ :!'4 ~ t. t;,,,,, cr~ i) & :J rtl i~ ~ tt. ,~ .~ ,"" ~~: '....' t....; t'<\ ........... '=::I f"- -- ~ '~';r :~~ :....,;;~ :~: ~2~ .~ ~ ~.r~ ~.} :: ~1 ~~ ~ -:: ::::; -: -: -::: - -::: S -::: -::: :::: - ::::; - - - :::: - - - - - -; ::::: -::: - ("\ in j~1 ~'I t . .t' \<.1 .,... '""l ..~ \'00 .,... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG. PA 1712B-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0791 07147592 11- 05-2007 REV-1543 EX AFP (09-00) EST. OF CHARLES E KISNER S.S. NO. 160-16-2298 DATE OF DEATH 08-18-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. SUSAN L STUART 202 N FRONT ST WORMLEYSBURG PA 17043 REMIT PAYMENT AND FDRMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BELCO COMMUNITY CU has provided the Department with the inforMation 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 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 calling (717) 767-8321. COMPLETE PART 1 BELOW Account No. 766518 lE lE lE SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 08-29-2001 x 5,879.79 50.000 2,939.90 .045 132.30 TAXPAYER RESPONSE 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". Established Acc,ount Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of ~den~ate of death, you may deduct a 5% discoun f the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!1 notic~ to obtain the Register of I C ::' B. 0 The above asset has been or will be reported and tax paid with the Pennsylvania 'l~h~ri ta!:,,~,~ Tax return to be filed by the decedent's representative. ; - , o 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 a discount or avoid interest, or you may check box "A" and return this notice; "to Wills and an official assessment will be issued by the PA Department of Revenue~ [CHECK ] ONE BLOCK ONLY C. 0 The above information is incorrect and/or debts and deductions were paid bY~o1L~ i \) 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 ~ DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 /32.3-0 L,. III IZ("I~l/ (~~) PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID Under penalties complete to the b t that the facts I ef. have reported above are true, correct HOME ("117 ) "1('}- ",{)Of:." WORK ("1(1) '2-'ll- )fut TFLEPHONE NUMBER and ll/fRlo? DATE ~ II\-