HomeMy WebLinkAbout05-28-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-961
NO. CD 009796
WOJTOWICH DARLA JEAN
278 STUMPSTOWN ROAD
MECHANICSBURG, PA 17055
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ESTATE INFORMATION: ssrv:
FILE NUMBER: 2108-0252
DECEDENT NAME: WOJTOWICH FOREST P
DATE OF PAYMENT: 05/28/2008
POSTMARK DATE: 05/27/2008
couNTY: CUMBERLAND
DATE OF DEATH: 02/29/2008
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
081 19129 ~ 53.61
TOTAL AMOUNT PAID:
53.61
CHECK# 602
INITIALS: CJ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280681
HARRISBURG, PA 17128-0681
INFORMA AND NOTICE FILE N0. 21 08-0252
;TAXPAYER RESPONSE ACN 08119129
-~ DATE 05-05-2008
REV-1443, EJ( R~P (09x00) __
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VANESSA WOJTOWICH
278 STUMPSTOWN RD
MECHANICSBURG PA 17055
TYPE OF ACCOUNT
EST. OF FOREST WOJTOWICH ®SAVINGS
S.S. N0. ^ CHECKING
DATE OF DEATH 02-29-2008 ^ TRUST
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU 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 Pennsylvania. Questions msv be answered by calling C717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 224594-0 0 Date 11-30-2002 To insure proper credit to your account, two
Established C2) copies of this notice must accompany your
Account Balance 481 • 23 payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Sub]ect to Tax 80.21 (3) months of the decedent's date of death,
Tax Rate X .045 You may deduct a 5Y. discount of the tax due.
Anv inheritance tax due will become delinquent
Potential Tax DUe 3 • 61 nine (9) months after the date of death.
PART TAXPAYER RESPONSE
. °: :: ;_::::: ::~: :. i?' ~ N :<::~tt ~~:::::R:E:U~~:::::~H:::::AH::#~;~:F~:IAI.:~::;'F;ASE::::A.~~:~~~~3:E~!1'I'::::HAS:EI#::::D~1::~:fiN:~:S::::::NDfi~:E:~~:
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
CHECK 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.
C ONE
B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y 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.
PART t a
If you indicate a differen t x r e 1 e a s e s ate a u r
at p t y € : .::::::::::::: ~:;::::; :: ?i €
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TAX P T ION
RETURN - COM U AT OF TAX ON JOINT/TRUST ACCOUNTS :".' : :::::::::::::::::::::~:
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1 a e st blished
D t E a 1
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2. Account Balance 2
3 e e t ax ble
P rc n T a
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mo n S b ect to Tax
A u t u 4
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5. Debts and Deductions 5 - ...,.$.,
6.
Amount Taxable
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7.
Tax Rate
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ax Due 8
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PART DEBTS AND DEDUCTIONS CLAIMED
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
TOTAL lEnter on Line 5 of Tax Computation) S
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. HOME C )
WORK ( ) ~J .
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
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