HomeMy WebLinkAbout03-18-08 (2)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EXI11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MCFARLAND GEGE G
456 DELANCEY CT
MECHANICSBURG, PA 17055
-------- fold
ESTATE INFORMATION: SSN: 207-42-3377
FILE NUMBER: 2108-0301
DECEDENT NAME: POOLE STEPHEN 0
DA TE OF PAYMENT: 03/18/2008
POSTMARK DATE: 03/17/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 12/18/2007
NO. CD 009424
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
08111667 I $115.74
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$115.74
REMARKS:
CHECK# 2426
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 01580\
08111667
03-17-2008
RE'V-lS43 EX AFP (09.DO)
TYPE OF ACCOUNT
DAVID M POOLE
465 DELANCEY CT
MECHANICSBURG PA 17055
EST. OF STEPHEN D POOLE
5.5. NO. 207-42-3377
DATE OF DEATH 12-18-2007
COUNTY CUMBERLAND
REMIT ~A~NT AND~~FRMS TO:
REGISTER oF. :1iILLS
CUMBERLAND;cn (C,OURE:~HOUSE
CARLISLE, PJAi.; :1:701 s'-l
CO
o SAVINGS
Ii] CHECKING
o TRUST
o CERTIF.
-'...,,,i)
-, (--..
..L-.-~
'./
SOVEREIGN BANK has provided the Department with the information listed below whicttl -F.~s been uS'lId in
calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU wer.'a joint owntrYbeneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institutio~"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 Pe!"!ns~'!var.i~. Questions may be answorcd by c311ing (717) 787..8321.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1681727986
Date
Established
08-11-1997
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
x
4,872.94
16.667
812.17
.15
121.83
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.
/ 'J,' r\
t>(.. .
..0'1
II $. 7
x
PART
[!J
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 "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.
If you indicate a different tax rate, please state your
relationship to decedent:
x
PART
@
TAX
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Est..blished
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 facts
complete to the best of my knowledge and belief.
//r~
have reported above are true, correct and
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