HomeMy WebLinkAbout01-16-08
COMMONWEALTH OF PENNSYl VANIA
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
SHENCK LISA
575 RED MILL RD
ETTERS, PA 17319
___n___ fold
ESTATE INFORMATION: SSN: 190-05-5420
FILE NUMBER: 2108-0056
DECEDENT NAME: HELSEL MARGARET L
DATE OF PAYMENT: 01/16/2008
POSTMARK DATE: 01/09/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 04/13/2007
NO. CD 009184
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07140091 I $36.62
I
I
I
I
I
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TOTAL AMOUNT PAID:
REMARKS: LISA SHENCK
CHECK# 6014
SEAL
INITIALS: OM
RECEIVED BY:
REGISTER OF WILLS
$36.62
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 ' (j a- Oofu
ACN 07140091
DATE 10-09-2007
REY-1543 EX AFP <09-00)
'-..4._..'
o
C'_
u_
EST. OF MARGARET L HELSEL
S.S. NO. 190-05-5420
DATE OF DEATH 04-13-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[i] CHECKING
o TRUST
o CERTIF.
L I SL ;u;-i.L SHENCK
575-RED ;K!~-L RD
E T T~R S '-' ;:=: ' P A 1 731 9
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
(~)
SOVEREIGN BANK 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 ma~ be answGred by c311ing {717} 787-2327.
Account No. 0571111769
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
Amount SUbject to Tax
Tax Rate
Potential Tax Due
PART
[!]
Date 04-07-1995
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".
4,882.29
X 16.667
813.73
X .045
36.62
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.
A. ~he 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. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
I
2
3 X
4
5
6
7 X
8
If you indicate a different tax rate, please state your
relationship to decedent:
PART
@]
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
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 DEBTS AND DEDUCTIONS CLAIMED
[!]
PAYEE
I L I '" t< . L. Cj) t'Jj(.J<-
DATE PAID
J-lJ-oq
DESCRIPTION
AMOUNT PAID
'3& .&~
TOTAL (Enter on Line 5 of Tax Computation)
$
HOME
TAXPAYER
facts
have reported above are true, correct
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