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Home My WebLink About10-30-07 (3) COMMONWEALTH OF PENNSYLVANIA BE, I"'\n II~NT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 P.EV-1162 EX(11-961 RECE!VED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NOLL BEVERLY M 588 W AREBA AVENUE HERSHEY, PA 17033 ---..---- fold.. ,,"""'c:......... ESTATE INFORMATION: SSN: 186-28-4088 FILE NUMBER: 2107-0979 DECEDENT NAME: MARTINI ANNA K DATE OF PAYMENT: 10/30/2007 . POSTMARK DATE: 10/30/2007 COUNTY: CUMBERLAND OATE OF DEATH: 08/26/2007 NO. CD 008877 ACN ASSESSMENT CONTROL NUMBER AMOUNT - 07145892 I $208.13 I I I I I I . , I I ,- .. TOTAL AMOUNT PAID: $'208.13 REMARKS: BEVERLY M NOLL CHECK# 891 .... SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS __.... _. '"' ~_ _ _~ _ _ 4" ~ ,., -r! t"; ~ 4. 0: t'j ~ ~ VI \~ (t. it ~ .""" ~ .,..i .,..i 'l Q.. 1". g N r U o ~ \ .('"\ <l)('"\ ;>0 ::=:<1:- o. - Z'~ ~< .Q...p.. .;S< . t~ t CO ~ 00... ~~ :g I ~ \r) ::::; -<0 :t:. v)\-,. -J~~ -J%~ ~~c:: -:::::.J ~~~ ~qCL '- ~ ~ \~ \G\ 'Q:.-.J __-JVj V)~- ~ \--0 -J \ ~~ ~ r-.. <:::;l: ~~~ ~ - ::= - - -::: - - - -::: - ::= ~ ~ ::= ~ :::::: ::= - - - - ~ == - - (,'.1 tn i') i') '-"- (.:i 'lot (') \'w .... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG. PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21-0'7 r Q'l9 07145892 10-25-2007 REV-15ti3 EX gp (09.00) EST. OF ANNA K MARTINI S.S. NO. 186-28-4088 DATE OF DEATH 08-26-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS D CHECKING D TRUST D CERTIF. 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 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 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 (711) 767-6~27. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ,r- J t:::~:: Account No. 5015208982 Date 04-29-1986 To insure proper Credit;~._ :,...J(,.o our acco~, two Established (2) copies of this notic.~:a.,u;st accomllilllY your payment to the Register ofCl(ills. M~. check payable to: "Register of Wl1I:;i; Agent.!.!.~ .;; C,) NOTE: If tax payments are made with~three (3) months of the decedent' 5 -date of death. you may deduct a 5% discount.Qf- the ~ due. Any inheritance tax due wtlIbecome ~inquent nine (9) months after the:~te of daatb. ~.c.~). r;..... Amount Subject to Tax Tax Rate x 9,250.07 50.000 4,625.04 .045 208.13 Account Balance Percent Taxable x Potential Tax Due PART ill TAXPAYER RESPONSE --,~ [CHECK ] ONE BLOCK ONLY A. 0 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. 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 information is incorrect and/or debts and deductions were paid by you. 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 I 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 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. HOME ( ) ~ WORK ( ) Tl:1 l:pJ.lnNI= NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* 21 - c/l~C1'7 Cj 07145892 10-25-2007 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. REV-lSU EX AFP (09. 00) EST. OF ANNA K MARTINI S.S. NO. 186-28-4088 DATE OF DEATH 08-26-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. BEVERLY M NOLL 588 W AREBA AVE HERSHEY PA 17033 REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS CUMBERLAND CO COURT ~SE CARLISLE, PAQ17013 :::::; -:~O ~~~ c~=; ,.... .~ PNC BANK has provided the Department with the information listed below which has be"n..~ed i...~ calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint~owner/be~ficiarY of this account. If you feel this information is incorrect, please obtain written correction froll the financial institUtion. attaeh a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Law~ of the'Ci.monwealth of Pennsylvania. Questions may be answered by calhng t71 n 787-8327. .) . COMPLETE PART 1 BELOW. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5015208982 Date 04-29-1986 Established 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". Account Balance Percent Taxable Amount Subject to Tax Tax Rate potential Tax Due 9,250.07 X 50.000 4,625.04 X .045 208.13 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death. you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART ill A. c=J 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. [CHECK ] ONE BLOCK ONLY 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 information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X a 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 a. Tax Due PART !!1 DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID have reported above are true. correct and HOME ( ) WORK ( ) Ti:l i:pl-lnNE NUMBER DATE Under penalties of perjury. I declare that the facts I complete to the best of my knowledge and belief.