HomeMy WebLinkAbout12-31-07
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
STROUP PATRICIA A
1532 INVERNESS DRIVE
MECHANICSBURG, PA 17050
-------- fold
ESTATE INFORMATION: SSN: 450-32-0507
FILE NUMBER: 2107-1177
DECEDENT NAME: HYEZDOS LOLA P
DATE OF PAYMENT: 12/31/2007
POSTMARK DATE: 12/29/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 09/12/2007
NO. CD 009129
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07145677 I $20.00
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TOTAL AMOUNT PAID:
REMARKS: PATRICIA A STROUP
CHECK# 2522
SEAL
INITIALS: OM
RECEIVED BY:
REGISTER OF WILLS
$20.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONtlEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE HO. 21 - 0 (- till
ACH 07145677
DATE 10-25-2007
REY-1543 EX ~p COt-DO>
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EST. OF LOLA P HYEZDOS
S.S. NO. 450-32-0507
DATE OF DEATH 09-12-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[i] CHE CK I NG
o TRUST
o CERTIF.
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mHA~~~~G PA
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17050-8328
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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PSECU 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 ill 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 .ay be ans-"ered by calling {717> 787-8327.
COMPLETE PART 1 BELOW
Account No. 8600158375
lit lit
lit SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date
Established
10-20-2001
To insure proper credit to your account, two
(2) copies of this notice .ust aCCOMpany your
pay.ent 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
x
5,744.94
50.000
2,872.47
.045
129.26
TAXPAYER RESPONSE
NOTE: If tax pay.ents are Made within three
(3) .onths of the decedent's date of death,
yOU .ay deduct a 5X discount of the tax due.
Any inheritance tax due will beco.. delinquent
nine (9) Months after the date of death.
x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
c=l The above inforMation and tax due is correct.
1. You May choose to reMit pay_ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or YOU .ay check box "A" and return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart_ent of Revenue.
r=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.
~ The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.p1ete PART 0 and/or PART ~ below.
Percent Taxable
OF TAX
1
2
3
4
5
6
7
8
x
ON .10 I t.}T ITRIJST ACCOUNTS
, 101 ~0/ ;:z.eOO/
'" 7 'l-ff. Cf 9
!5'o. 00
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;ty;2~.oo
Ifcf<f . f- 7
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;2 0.00
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship to decedent: -pAU t::'::,11T"'~/l;
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3.
4.
5.
6.
7.
8.
Amount Subject to Tax
Debts and Deductions
Amount Taxable
Tax Rate
x
Tax Due
PART
(!]
DATE PAID
PAYEE
AMOUNT PAID
.00
TOTAL (Enter on Line 5 of Tax Computation)
.
.00
perjury, I declare that the facts I have reported above are true, correct and
my knowledge and belief.
( 7/ 7) -??,? - ~~ 7 ?
WORK ( )
TELEPHONE NUMBER
DATE
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