HomeMy WebLinkAbout02-11-08
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
NO. CD 009285
KLINE WANDA F
1812 ELF DIVE
SEBRING, FL 33875-5510
CONTROL
NUMBER
nn____ fold ---------- --------
08500026 I $192.20
ESTATE INFORMATION: SSN: 177-24-5674 I
FILE NUMBER: 2108-0135 I
DECEDENT NAME: KLINE CATHERINE F I
DATE OF PAYMENT: 02/11/2008 I
POSTMARK DATE: 02/08/2008 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 11/21/2007 I
I
TOTAL AMOUNT PAID: $192.20
REMARKS:
CHECK# 1781
INITIALS: CJ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
ACN
ASSESSMENT
AMOUNT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
.oM..__
,'~"
INFORMATION NOTICE
AND
,TAXPAYER RESPONSE
REVISED NOTICE *
FILE
ACN
DATE
NO.21
08500026
01-31-2008
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*
* *
CLERf<.
ORD-J,{:J'YS' tYJ'l' Jf:F
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CU\" :J,LI
EST. OF CATHERINE F KLINE
5.5. NO. 177-24-5674
DATE OF DEATH 11-21-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SECURITY
[Xl SEC ACCT
o STOCK
o BONDS
2008 FEB I I Prll2: 20
ROBERT W KLINE
1812 ELF DRIVE
SEBRING
FL 33872
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMERICAN FUNDS has provided the Deparbent with the inforllation 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 beneficiary of this asset.
If you feel this infor.ation is incorrect, please obtain written correction froll the transfer agent, attach a copy to this for. and
return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COllllonwealth of Pennsylvania.
Questions .ay be answered DY calling (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 64665121
x
17,983.92
25.000
4,495.98
.045
202.32
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice lIuSt accolIPany your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
DOD Valuation
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
NOTE: If tax paYllents are lIade within three
(3) 1I0nths of the decedent's date of death,
you lIay deduct a 5% discount of the tax due.
Any inheritance tax due w~~l become delinquent
nine (9) 1I0nths after the date of death.
PART
[!]
The above inforllation and tax due is correct.
1. You lIay choose to re.it paYllent to the Register of Wills with two copies of this notice to obtain
a discount Dr avoid interest, Dr you lIay check box "A" and return this notice to the Register of
Wills and an official assessllent will be issued by the PA Departllent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. OThe above asset has been Dr will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. OThe above inforllation is incorrect and/or debts and deductions were paid by you.
You IIUSt cOIIPlete PART ~ and/or PART ~ below.
PART If you indicate a different tax rate, please state your
~ relationship to decedent:
TAX TAX ON ABOVE ASSETCS)
LINE
RETURN - COMPUTATION OF
1. DOD Valuation 1
2. Percent Taxable 2
3. Amount Subject to Tax 3
4. Debts and Deductions 4
5. Amount Taxable 5
6. Tax Rate 6
7. Tax Due 7
x
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
$
Under penalties of perjury, I declare that the facts
complete to the best of my knowledge and belief.
have reported above are
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TAXPAYER SIGNATURE
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