HomeMy WebLinkAbout12-20-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1712B-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BOWMAN JOHN
5430 BONNYRIGG COURT
MECHANICSBURG, PA 17050
______d fold
ESTATE INFORMATION: SSN: 339-12-4890
FILE NUMBER: 2107-1152
DECEDENT NAME: BOWMAN LOYETTE H
DA TE OF PAYMENT: 12/20/2007
POSTMARK DATE: 12/1 9/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 09/07/2007
NO. CD 009097
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07144864 I $121.68
I
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 4173
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$121.68
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEAL TH OF PENNSYlVANIA
DEPARTMENT DF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
FILE
ACN
DATE
NO. 21 b 1 \ \ c:; ?
07144864
10-24-2007
~
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV.1Sli3 EX AFP (09-00>
-:; 0 TY~ OF~I;~UNT
EST. OF LOYETTE H BOWMAN1:.~.~~ ~ cr;. ~:~VINGS
. T \. ) (J-u.lL ')
S.S. NO. 339-12-4890':=;)T1 N ~~~~1!ECKIN~
DATE OF DEATH 09-07-20-lJ7:;) CI (]'.T:8UST
---'.-".'"..'"
COUNTY CUMBERLAND' ~~:<) " (C}~~RTIF.
.' \....i --Tl -r _ - 11
REMIT PA'{}I~T AND F]lBMS TO:: c-'S
REGISTER OF ~LS r:-? ; - rT1
CUMBERLAND ~ COURT c.WJuse.)
CARLISLE, PA 17013 0'\
JOHN BOWMAN
5430 BONNYRIGG CT
MECHANICSBURG PA 17050
MEMBER 1 ST FEDERAL C U has provided the Deparbent 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 Com.onwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 160793-11
Date 08-03-1996
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
PART
ill
5,407.96
X 50.000
2,703.98
X .045
121. 68
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.
The above information and tax due is correct.
1. You .ay 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=l 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.
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX
LINE l. 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)
$
facts I
have reported above are true, correct
HOME (7/7) 737-8'189
WORK (In ) ~lf (-77 9CJ
T~L~PHONE NUMBER
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DATE (
Under penalties of perjury, I declare that the
e .t~ t~s~ my knowledge and belief.
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and
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