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HomeMy WebLinkAbout05-19-08 (4) 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 ___uu_ fold ESTATE INFORMATION: SSN: FILE NUMBER: 2108-0255 DECEDENT NAME: GA WRONSKI WINNONA WELS~ DATE OF PAYMENT: 05/19/2008 POSTMARK DATE: 05/17/2008 COUNTY: CUMBERLAND DATE OF DEATH: 03/04/2008 NO. CD 009756 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08120021 I $9.93 I I I I I I I I TOTAL AMOUNT PAID: $9.93 REMARKS: CHECK# 2932 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280&01 HARRISBURG, PA l7l2B-060l ..''"'.''.-.,...., "..' ~.:..:l<. .):_' - ;,: "-'\ < - ,'/:; ( INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 08-0255 08120021 05-12-2008 200BHAY 19 Pi'11:34 EST. OF WINNONA GAWRONSKI 5.5. NO. DATE OF DEATH 03-04-2008 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST [i] CERTIF. CLEfii< OF ORPH.AN'S COURT CU~,p:'T' PA BRENDA C TEWELL 326 CANDLELIGHT DR MECHANICSBURG PA 17055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has p...ovided the Depa...tment with the info...mation listed below which has been used in calculating the potential tax due. Thei... ...eco...ds indicate that at the death of the above decedent, you we...e a joint owne.../beneficia...y of this account. If you feel this info....ation is inco......ect, please obtain w...itten co......ection f...om the financial institution, attach a copy to this fo...m and ...etu...n it to the above add...ess. This account is taxable in acco...dance with the Inhe...itance Tax Laws of the Commonwealth of Pennsylvania. Questi~ns may be answe...ed bv calling (711) 181-8321. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 200142-40 Date 05-05-2004 Established To insure proper credit to your account, two (2) copies of this notice must accompany you... payment to the Registe... of Wills. Make check payable to: "Registe... of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 1,393.81 X 16.667 232.31 X .045 10.45 TAXPAYER RESPONSE NOTE: If tax pay.ents a...e made within th...ee (3) months of the decedent's date of death, you .ay deduct a 5% discount of the tax due. Any inhe...itance tax due will become delinquent nine (9) months afte... the date of death. PART [!] [CHECK ] ONE BLOCK ONLY A. r/fThe above info...mation and tax due is co......ect. ~ 1. You may choose to ...emit payment to the Registe... of Wills with two copies of this notice to obtain a discount 0'" avoid inte...est, 0... you may check box "A" and ...etu...n this notice to the Registe... of Wills and an official assessment will be issued by the PA Depa...tment of Revenue. B. r=J The above asset has been 0... will be ...epo...ted and tax paid with the Pennsylvania Inhe...itance Tax ...etu...n to be filed by the decedent's ...ep...esentative. C. [] The above info...mation is inco......ect and/o... debts and deductions we...e paid by you. You must complete PART ~ and/o... PART ~ below. If you indicate a different tax rate. please state your ...elationship to decedent: LINE l. Date EstCi:'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 RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS X DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. Trtt~s'~ have reported above are true, correct and (/1') ~c.t; ~ ;;;:~3t1 WORK C:7 r7 ) 70 s - 39'/~ 1P7 /0 .~ TELEPHONF NIIMR~P n .. HOME ~ "'" , .'..\ (.1 ~, \)1 ~. ,,\ i;} d~ N "", ~ -;\ :::t ~ ~ ~ -\ ~, !'. - ~')' - ~~' ~~ ~ ......~ --.\~ <:) :A, ',: ,}, ~) ,,~~ ~ ~~ ~ :::. -- ~ ~ 'J\ ..fi \ ' );-, "'- y. r' ~(. i'\ ~ \j -::" :.,.. f ~ ~ * - .. * ~ ~ .. -::z. * * * ~ ? - ~ * :- -:=:;. ;..- ~ r- * '::::' ~ - ~ c-, '" ) ~ ""' C'\ ~ ~ '~ ~~ 't V~ ~ "- '\"':' ~ ~ ",1\ rIo.. _ \ \' ::,\r\f'\ ",.ct'.-."'\.' \oJ .'0(\ ,.:,:,.....-:.,...110 \..11 \,)! ,,' ,'.,' \1:d \10 ~C ~,,,.-, '-.'. i '.,' ;; ", .U \ \ ,\ \\.!,.J ~;.":"(\ j.; j(\ ,,},.f~, \...J ..J\,j /\L)--' ,. \ t; \ i" 'Ii~. . \ ;~' 1 , , , , , , , , , I , ..: , , , , , , , " , , , '. "$. ..~ .~, \'.' n --:).. " o'j, \J} '"rj, -t ~ ..~ ,-' :"'l~ ':,-li u ....) '.,.;.::' \