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HomeMy WebLinkAbout03-14-08 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 NEUMYER WILLIAM H 405 MOUNTAIN ROAD SUMMERDALE, PA 17093 ____un fold ESTATE INFORMATION: SSN: FILE NUMBER: 2108-0289 DECEDENT NAME: NEUMYER LILLIAN L DATE OF PAYMENT: 03/14/2008 POSTMARK DATE: 03/14/2008 COUNTY: CUMBERLAND DATE OF DEATH: 12/06/2007 NO. CD 009413 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $141.25 I I I I I I I I TOTAL AMOUNT PAID: $141.25 REMARKS: CHECK# 3118 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~ .t/' COMMOl1YteA.\...TH 'OF P~"'NSVLV"'N.IA. DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG. PA 1712B-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 D~ () ~ '6' 08111279 03-12-2008 REV-15li5 EX AFP (09-00) EST. OF LILLIAN L NEUMYER S.S. NO. DATE OF DEATH 12-06-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. WILLIAM H NEUMYER 5255 WERTZVILLE RD ENOLA PA 17025-1260 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 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 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 answ&red by callir.g {7I,; ,37-5327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0207077491 Date 11-19-2004 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 2,354.19 X 50.000 1,177.10 X .12 141. 25 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death. you may deduct a 5% dis ount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. ~ 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 "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. [] 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. x PART ~ TAX If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Establisheti 1 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART [!] DATE PAID PAYEE x DEBTS AND DEDUCTIONS CLAIMED DESCR I PTI ON AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I declare that the complete to the best of my knowledge and belief. a/d~ # /~~..i~ _"'.................. _T,........TIIr'J1""" facts I have reported above are true, correct and 7 :5 L ..1..l.f- ()3 (711) WORK ( ) TELEPHONE NUMBER HOME DATE