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COMMONWEALTH OF P~E NSYL+VP"JIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 009565
DIGIANDOMENICO MICHAEL G JR
438 W 2ND STREET
BERWICK, PA 18603
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ESTATE INFORMATION: ssN: X97-os-9278
FILE NUMBER: 2108-0431
DECEDENT NAME: DIGIANDOMERNICO MICHAEL
DATE OF PAYMENT: 04/ 1 5/2008
POSTMARK DATE: 04/ 1 4/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 01 /25/2008
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08112920 ~ 594.05
TOTAL AMOUNT PAID:
REMARKS: DIGIANDOMENICO MICHAEL JR
CHECK#1851
SEAL
INITIALS: WZ
594.05
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA G
DEPARTMENT OF REVENUE I N F O R MAT I O N NOTICE .- C~~O ~~
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21
DEPT. 280601 ACN 0$112920
HARRISBURG, PA 171za-o6ol TAXPAY E R R E S P O N S E
DATE 03-20-2008
REV-1543 E% AFP (09-00)
TYPE OF ACCOUNT
EST. OF MICHAEL G DIGIANDOMENICO ^ SAVINGS
S.S. N0. 197-09-9278 ^ CHECKING
DATE OF DEATH 01-25-2008 ^ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PANT AND F~IS T0:
MICHAEL G DIGIANDOMERNICO REGISTER OF =]a~LS
C/0 438 W 2ND ST CUMBERLAND CD-COURT >~@USEr'? i+ '"
BERWICK PA 18603 CARLISLE, PA7-913 ~ -~' -
~1 '
~..~..) .Y~ _
FNB BANK has provided the Department with the information listed below which- has~een used.=a,n -_-` ~~
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were ~~~oi t owner/DEneficliar~rt_of
this account. If you feel this information is incorrect, please obtain written correction from the financial'institutian, 0)9tach a~cop~r-':~
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of ~ Commonwealth
of Pennsylvania. Questions may be answered by calling U17) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 011-3000868 Date 08-20-2002 7o insure proper credit to your account, two
Established (2) copies of this notice must accompany your
Account Balance 4,399.85 payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax 2, 199.93 (3) months of the decedent's date of death,
Tax Rate X .045 you may deduct a 5Y. discount of the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due 99.00 nine (9) months after the date of death.
PART TAXPAYER RESPONSE
::.:.~':~i:'F~:t~l~'I!$" :~:T~'1::.~~.~."~~#'1~i~...,,L1'1 ~:,{:,.,:,_'~' ~"~II,E<"EK__.'lEi7....lE~;[.";Yf:C~C:T.J!~i?F.:iFiE[~iFii'~~%X:~:~:ilk'~'%~1~4`:C%i?37P1~~1?TE[:~:~:~i~:IC~fC~}:jfiii`i~;yIFE31`?iK~G~`:~~firi~TT6i•i!w[iFiF.
A. he above information and tax due is correct.
1. You may choose to renit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check b ox "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
0 N E ~
B L 0 C K g. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y 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 2^ and/or PART 3^ below.
PART Y i t a different tax rate, please state your
€iisiii~if':i€iifi€isiE_f€ss~~i`:`i~i~Ai~.: i'i;:;t~;€'€~~.
relationship to decedent. -
TAX RETURN - COMPIITATION
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
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7__X
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
WORK C~~~) °.75 d-.~~.Z._- -~ ~-"
TELEPHONE NU ER ~ DATE
TOTAL CEnter on Line 5 of Tax Computation) 8
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
.-.
~ compl ~te ~ , tp~e be ^ f my`kno~edge and belief . HOME FS ~~ ) ~9 ~'~