HomeMy WebLinkAbout03-26-08
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128.0601
REV.1162 EX(11.96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ULRICH SANDRA R
2 BOXWOOD CIRCLE
YARMOUTH PORT, MA 12675
-------- fold
ESTATE INFORMATION: SSN:
FILE NUMBER: 2108-0344
DECEDENT NAME: REIMER ELEANOR D
DATE OF PAYMENT: 03/26/2008
POSTMARK DATE: 03/22/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 11/30/2007
NO. CD 009456
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
08108120 I $363.37
I
I
I
I
I
I
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TOTAL AMOUNT PAID:
$363.37
REMARKS:
CHECK# 4184
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 0'6 a?t\L\
08108120
03-04-2008
REV-1543 EX AFP (09-00>
EST. OF ELEANOR D REIMER
S.S. NO.
DATE OF DEATH 11-30-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[i] CHECKING
o TRUST
o CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA ~7013
SANDRA R ULRICH
2 BOXWOOD CIR
YARMOUTH PORT MA 12675
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PNC BANK has provided the Department with the information listed below which has bee" ,us,ed if'., ,
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, att~ a copy
to this form and return it to the above address. This account is taxable in accordance wi'(h the Inheritance Tax Laws'of the ~monwealth
of Pennsylvania. Questions may be answered by calling (717) 787-6327. '
Account No. 5140052067
COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION$~
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
ill
Date 08-27-2002
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".
16,149.97
X 50.000
8,074.99
X .045
363.37
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.
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. [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.
OF TAX ON JOINT/TRUST ACCOUNTS
I
2
3 X
4
5
6
7 X
8
PART
@]
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please state your
relationship to decedent:
LINE 1. 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
@]
DATE PAID PAYEE
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 I
~comPl~te to~ best of my knowledge and belief.
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TAYPAV~R ~TGNATURE
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