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Home My WebLink About05-19-08 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.2B0601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TEWELL BRENDA C 326 CANDLELIGHT DRIVE MECHANICSBURG, PA 17055 -------- 'fold ESTATE INFORMATION: SSN: FILE NUMBER: 2108-0255 DECEDENT NAME: GAWRONSKI WINNONA WELSI DA TE OF PAYMENT: 05/19/2008 POSTMARK DATE: 05/17/2008 COUNTY: CUMBERLAND DATE OF DEATH: 03/04/2008 NO. CD 009753 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08120023 I $143.06 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2833 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS $143.06 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 08-0255 08120023 05-12-2008 REV-1543 EX AFP C09-00) EST. OF WINNONA GAWRONSKI S.S. NO. DATE OF DEATH 03-04-2008 COUNTY CUMBERLAND l[YPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [i] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COU~T~OUSE CARLISLE, ~ 1701325 ~O .. <= ,-c; ::n ::M: ::g > ---c,...LO -< --: .~~Eij wi MEMBERS 1 ST FCU _ has prov~de~ the Deparhent with the information listed below whit_h)~~/.;;en used in , ,_:~_.. calculating the potential tax due. Thelr records lndlcate that at the death of the above decedent, you were ~~ own~eneficia~~of this account. If yoU feel this information is incorrect, please obtain written correction from the financi~l5~ti utio~ttacb ~ to~ to this for. and return it to the above address. This account is taxable in accordance with the Inheritance TV Laws ot;;S'e CO....!>~!;llth of Pennsy11/ania. Questions Rlay be answer,gd bY eal1ing (717) 787-8327. .:J,:) ---c ~.. :,' I COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYME~ INSTRU~ONS ~ BRENDA C TEWELL 326 CANDLELIGHT DR MECHANICSBURG PA 17055 Account No. 200142-47 Date 12-27-2000 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". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 20,077.75 X 16.667 3,346.36 X .045 150.59 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 [!] [CHECK ] ONE BLOCK ONLY A. ..[71 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. 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. c=J The above information is incorrect andlor debts and deductions were paid by YOU. You must complete PART ~ andlor PART ~ below. LINE l. Dat.. Esta~lished 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 PART ~ TAX If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS x DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ perjury, I declare that the facts and belief. HOME WORK es :21 Wd 61 AVU BOOl to \\ ~ '< .\ :, '\ \ > ., " " ;'I ~, ~ ~ ~, ;I .~ ,~ ,. . , ~ 'r: .,~: 1'"1 , ~. .t M, {"i" """. f.Jj r:.t., r, --;) ?5 jiq1 t9 1;1 l"'! :" ~ < ,.... .... w.I ,.". ~ 0.. , ',... ~ t t,.;, ~ . ~_..-:A'~ :- . ,..: A ~ ? l i. ~ . j ) ~ ) I I ) . ~~ ; ";~\J~ : ~.~ ~ \~~~ ~" '" ~ ~~ ~ " ~ Vt ~ " " (0 .~ '< '~ ~ ~' (~ ~ ~\.J "- ~ 'J <;:-.f{ ~ Q "- ~ ~ 'i ~ ~ \;'\ ~ .r: -~ ~ " f\f'~, ~ \~ \J \J \./.J(','j 'J' ',' :,~'::')/\inl"\ V(J V~ , , '. 1'-1_,,,, V ltirJOJ S,tVV'HdHO dO )fH3iJ - - - - ~ - - - - ::::: - - - - -:: ::: ~ ~ - - =E - - - -: - -. '"': - ('.' III ,l" f') + f') ....., t.:i ,.-- .,.."