HomeMy WebLinkAbout03-28-08
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 009468
RECEIVED FROM:
MOWERY LAURIE
1215 WILLIAMS GROVE ROAD
MECHANICSBURG, PA 17055
CONTROL
NUMBER
_n_____ fold ---------- --------
07137869 I $209.81
ESTATE INFORMATION: SSN: 207 -05-9793 I
FILE NUMBER: 2107-0913 I
DECEDENT NAME: BURD GAL YN L I
DATE OF PAYMENT: 03/28/2008 I
POSTMARK DATE: 03/27/2008 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 06/30/2007 I
I
TOTAL AMOUNT PAID: $209.81
REMARKS:
CHECK# 334840
INITIALS: 071
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
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21- (/7 -ijtl ?
07137869
08"29-2007
REV-1543 EX AFP (Og-OO)
EST. OF GALYN L BURD
S.S. NO. 207-05-9793
DATE OF DEATH 06-30-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[XJ CHECKING
o TRUST
o CERTIF.
LAURIE MOWERY
1215 WILLIAMS GROVE RD
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK 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. Ques~ions m~y be answered hy calling (717) 7B7-B327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140111899
Date 02-01-1970
Established
To insure proper credit to your account, two
C2) 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
27,973.70
X 16.667
4,662.38
X .045
209.81
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.
PART
[!J
A. ~he 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.
[CHECK ]
ONE
BLOCK
ONLY
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
LiNt:. 1- !late t:stabllsheo
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
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation)
$
facts
have reported above arel truet) c.?rl-ect~n I .
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