HomeMy WebLinkAbout05-27-08
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
WOJTOWICH DARLA JEAN
278 STUMPSTOWN ROAD
MECHANICSBURG, PA 17055
-------- fold
ESTATE INFORMATION: SSN:
FILE NUMBER: 2108-0252
DECEDENT NAME: WOJTOWICH FOREST P
DA TE OF PAYMENT: OS/27/2008
POSTMARK DATE: OS/22/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 02/29/2008
NO. CD 009792
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
08119132 I $3.20
I
I
I
I
I
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TOTAL AMOUNT PAID:
$3.20
REMARKS:
CHECK# 603
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 08-0252
ACN 08119132
DATE 05-05-2008
REV.1543 EX AFP (09-00l
TYPE OF
ACCOUNT
Ii] SAVINGS
o CHECKING
o TRUST
o CERTIF.
EST. OF FOREST WOJTOWICH
5.5. NO.
DATE OF DEATH 02-29-2008
COUNTY CUMBERLAND
~
REMIT PAY~T AND FO~ TO:
REGISTER OF iiljQs ~
CUMBERLAND CQ]~URT HOUSE
CARLISLE, PAj't1;04.3 -<
'/nl N
, .'.' ;:.';c~ -...l
() 0 -0
~2 " 3;
MEMBERS 1 ST FCU has provided the Department with the inforllation listed below which h~ ~en used ~ , " T .
calculating the potential tax due. Their records indicate that at the death of the above decedent. you were a)jOint owner/baAeficiary of
this account. If you feel this information is incorrect. please obtain written correction from the financial institution. ~ch a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questi~ns may be an$wered bY calling (7171 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
VANESSA WOJTOWICH
278 STUMPSTOWN RD
MECHANICSBURG PA 17055
Account No. 224594 -11
Date
Established
02-25-2006
To insure proper credit to your account, two
(2) copies of this notice lIust accollpany 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
ill
x
426.49
16.667
71. 08
.045
3.20
TAXPAYER RESPONSE
HOTE. 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 becolle delinquent
nine (9) months after the date of death.
x
[CHECK ]
ONE
BLOCK
ONLY
A. [] 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 .~" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. [J 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. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate. please state your
relationship to decedent:
LINE 1. Date Estab11shad
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
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.
l/(a.,u;!1 l//. 4-
TAXPAYER SIGNA URE
have reported above are true. correct and
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