HomeMy WebLinkAbout04-14-08
COMMONWEP.LTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KENNEDY BERNADETT P
561 BRENTWATER ROAD
CAMP HILL, PA 17011
___u___ fold
ESTATE INFORMATION: SSN: 281-34-2960
FILE NUMBER: 2108-0417
DECEDENT NAME: POL/SSO MINNIE N
DA TE OF PAYMENT: 04/14/2008
POSTMARK DATE: 04/11/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 08/10/2007
NO. CD 009549
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
07140925 I $19.49
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 610
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$19.49
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
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NO. 21 C~ D"1n
07140925
10-10-2007
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
-REV~'1~3_"EX AFP (09.00)
EST. OF MINNIE N POLISSO
S.S. NO. 281-34-2960
DATE OF DEATH 08-10-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[i] CHECKING
D TRUST
D CERTIF.
2008 APR I 4 PM I: ! 3
CLEPK OF
ORPHI'\:\!'S CJURT
eu'., PA
BERNADETT P KENNEDY
561 BRENTWATER RD
CAMPHILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
INTEGRITY 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 Pennsyl'.-aniu4 Questioris May be answered by cCilling (717) 787-g~27.
Account No. 201013431
COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
07-12-2005
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
PART
[!1
Date
Established
x
866.35
50.000
433.18
.045
19.49
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.
x
A. IQ\ 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. [] 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. r=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
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)
facts
have reported above are true, correct
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TELEPHONE NUMBER
and
$
Under penalties
com?~;i
,.."nav n ~T"" ATIIDI:'
of perjury, I declare that the
of my knowledge and belief.
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