HomeMy WebLinkAbout04-07-08
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 009513
CUTILLO BARBARA I
416 PROWELL DRIVE
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
____un told ---------- --------
08111008 I $275.92
ESTATE INFORMATION: SSN: 180-01-8350 I
FILE NUMBER: 2108-0395 I
DECEDENT NAME: KRACZYK HELEN L I
DATE OF PAYMENT: 04/07/2008 I
POSTMARK DATE: 04/20/2008 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 09/18/2007 I
I
TOTAL AMOUNT PAID: $275.92
REMARKS:
CHECK#1249
INITIALS: CJ
SEAL RECEIVED BY: GLENDA FARNER STFlASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
BARBARA I CUTILLO
416 PROWELL DR
CAMP HILL
,*,. (',0--
":',_ ,..'.' '.,1 i' I.
. ,.' J. -, ~-
FILE
ACN
DATE
NO.
21 .D~-03q5
08111008
03-12-2008
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV"l~S fX foFP' ~~9--~~)
'HH1Q n?P -1
I." IJ L ." \\
PI1 I: 08 EST. OF HELEN L KRACZYK
S.S. NO. 180-01-8350
DATE OF DEATH 09-18-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECK I NG
o TRUST
[X] CERTI F .
ORF" V
r:.:
-...1:
;~~.(jlJRT
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REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PA 17011
FOX CHASE BANK has provided the Department with the information listed below which has !,een used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joilnt 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 Pen~~vlvanja. Pue~~jon5 ~ay be ~nswpred by c~11ir.9 (7171 787-8377.
Account No. 240847212
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
ill
Date 02-13-1991
Established
To insure proper credit to your account, two
CZ) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent",
12,263.02
X 50.000
6,131.51
X .15
919.73
TAXPAYER RESPONSE
NOTE: If tax payments arl:t made wi thin three
(3) months of the decedent's date of death,
you may dedc -t a 5% disco'Jnt of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
A. D The
1.
[CHECK]
ONE
BLOCK
ONLY
above information and tax due is correct.
You may choose to remit payment to the Register of Wills with two copies of this
a discount or avoid interest, or you may check box "A" and return this notice to
Wills and an official assessment will be issued by the PA Department of Revenue.
notice to obtain
the Register of
B. D 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.
2
3
4
5
6
7
8
PART
[!]
TAX
If you indicate a different.-;\ax r.atel p.le.C!se state your
relationship to decedent: ,_YCLtu.l- rt1:::t
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1 . Date Est=~15shcd
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
I?~ Z i.:> ~7:> . 0 2..-
xl.:tO. 0 ,l ()
1~/3J..,.51
~ l3(~51
X . 0+5
,47~. q~
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
$
declare that the facts
and belief.
have reported above are true, correct and
HOME (711 )/7& (-u Lg 3
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