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Home My WebLink About05-19-08 (2) COMMONWEALTH 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 TEWELL BRENDA C 326 CANDLELIGHT DRIVE MECHANICSBURG, PA 17055 n__n__ fold ESTATE INFORMATION: SSN: FILE NUMBER: 2108-0255 DECEDENT NAME: GAWRONSKI WINNONA WELS~ DA TE OF PAYMENT: 05/19/2008 POSTMARK DATE: 05/17/2008 COUNTY: CUMBERLAND DATE OF DEATH: 03/04/2008 NO. CD 009754 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08120025 I $314.28 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2934 SEAL INITIALS: AJW RECEIVED BY: REGISTER OF WILLS $314.28 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 08120025 05-12-2008 REV.1543 EX AFP (09-00) EST. OF WINNONA GAWRONSKI S.S. NO. DATE OF DEATH 03-04-2008 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS D CHECKING o TRUST !Xl CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS. CUMBERLAND ~ COURT HaUSE CARLISLE, P~d 7013 gg .,"':; ::0 __ .. lJ ........ . " :r: () :::.. -'.,c )> r- -< ;.~ (Ji 32 \0 MEMBERS 1ST FCU has provided the Department with the information listed below which~:i1jSJ l!!J'n used in '.'--, calculating the potential tax due. Theil' records indicate that at the death of the above decedent, you wer~,. ~~ owne~enefil:ial'Y'lJf this account. If you feel this information is incorrect, please obtain written correction from the financi~~,J~titution~ttach a. c.op~ to this form and return it to the above address. This account is taxable in accordance with the Inheritan~~ Laws of~e Comm~e~th of Pennsylvania. Questions may be answered by calling (717) 787-8327. ~.., COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUG!}ONS BRENDA C TEWELL 326 CANDLELIGHT DR MECHANICSBURG PA 17055 Account No. 200142-45 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART [!] Date 01-02-2003 Established To insure proper credit to you~ account, two (2) copies of this notice must accompany your payment to the Register of Wilts. Make check payable to: "Register of Wills. Agent". 44,108.45 X 16.667 7,351.56 X .045 330.82 TAXPAYER RESPONSE NOTE: If tax payments are mad~ 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. A. ~The above information and tax due is correct. ~l. You may choose to remit payment to the Register of Wills with two copies of this nolice to obtain a discount 01' avoid interest, 01' you may check box "A" and return this notice to th" Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. c=J The above asset has been 01' will be reported and tax paid with the Pennsylvania Inherit~nce Tax return to be filed by the decedent's representative. C. c=J The above information is incorrect and/or debts and deductions were paid bY you. You must complete PART ~ and/or PART ~ below. 1 2 3 X 4 5 6 7 X 8 PART ~ TAX If you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date ~stablished 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 DESCRIPTION AMOUNT PAID $ TOTAL (Enter on Line 5 of Tax Computation) I have reported above are true, correct and C"7/1 ) -;(/ t;.- Z-z 3V C.?! ) ?t:'<[; ?:HV~- T~I ~pl-lnN~ NIIMRI=P Under penalties of perjury, I declare that the facts I knowledge and belief. TA HOME WORK 5;;~/r.' y nA"~ CS :21 ~d 61 '(t'U Buill ~ ,\ ,;t < .\ :, '\ \ > " " ,., " :- ~, ~ ~ ~. ;/ .' , ,~ ., . , ~ ,.,J .;: ~~, ~ -;...r: ,; , ft.: ; ~ ~ " --j, fu (;1 l"'! t;( ~ ,At( .... .... .... ~ 0.. . ~ ?S {".J -,... ~ ~ .<10. t'." ;,., ---~ :> . ,..: - ~ ? .~ . i ) ~ , ) I I ) . ~~ ; '\,-\J~ : \.:'.~ ~ \~~~ I It' ~ tn ~~ ~ " "- V1 ~ ! "r/) ~~ ~ \' ~J e ~ 'J <0~ ~ Q "- ~ ~ .{ ~ ~ \t\ ~ ~ -~ ~ ~ \\t~J ~ \./...1 ;-"'j 'j!.' :-I'I~'::-)/\lnl"\ V(J v~ , '\'. '-'_<,.. v l!::JnOJ S,NVHd!::JO .:10 YH3iJ - - - - - - - - - :::: - - - - - -:: ::: - - - ~ - - -. ""': - - -= - ".., 11~ ,l,) ,..) + (.) 'M () ,... .,."