HomeMy WebLinkAbout07-01-08COMMONWEALTH OF PENNSYLVANIA
DEPARTICIENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162EX111-96)
N0. CD 009974
EDWARDS WILLIAM D
3709 FALKSTONE DRIVE
MECHANICSBURG, PA 17050
fold
ESTATE INFORMATION: ssN: Aso-14-3848
FILE NUMBER: 2108-0702
DECEDENT NAME: EDWARDS LOUIS S
DATE OF PAYMENT: 07/03/2008
POSTMARK DATE: 06/30/2008
couNTY: CUMBERLAND ~~
DATE OF DEATH: 05/20/2008
REMARKS:
CHECK# 2124
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08124279 ~ 595.54
TOTAL AMOUNT PAID:
INITIALS: CJ
RECEIVED BY:
595.54
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE //,,
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21~-0~-(17d•1+
DEPT. 280601 ° ^r~*'+' ACN 08124279
HARRISBURG, PA 171za-o6o1 -,r ~ :. 4 TAXPAYE R R E S P O N S E
r ,~~a~aKr. I `~ DATE 06-03-2008
r~~^~
pRPI-V•~~f'S ~n
~~~{i.Al~1D CA... '
WILLIAM EDWARD
3709 FALKSTONE DRIVE
MECHANICSBURG PA 17050
TYPE OF ACCOUNT
EST. OF LOUIS S EDWARDS ® SAVINGS
S.S. N0. 160-14-3848 ^ CHECKING
DATE OF DEATH 05-20-2008 ^ 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 may be answered by calling C717) 787-8327.
COMPLETE PART 1 BELOW * * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 255280-0 0 Date 12-03-2004 To insure proper credit to your account, two
Established C2) copies of this notice must accompany your
13,408.76 payment to the Register of Wills. Make check
Account Balance payable to: "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to TaX 2, 234.84 (3) months of the decedent's date of death,
Tax Rate X .045 you may deduct a 5Y. discount of the tax due.
1 0 0 .5 7 Any inheritance tax due will become delinquent
Potential Tax Due nine (9) months after the date of death.
PART TAXPAYER RESPONSE
,,,.;... .~ ~ .. a :::.......:::.:
e:,:,:~:e'?l;!E,~~e~(~ 'ref:::::~~.'~%~1~1'ii~L::::i~.T.~::3:::::::~.'if~Ifiei#~3_?!~::e::4~~a.,,.~,aCiE__ ":w•ii'iii'iii:~L:i1'Sii~ Fit'yi:aeliGlei~arriarwiii~ii~.:sex.;:irui:•::,:•~::J::~....'3cu: i::::•:::~E•ie;siii~i_ °.u:e !uai.Y.__..i:5?EEpEeF;F
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
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ^ The above asset has been or well be reported and tax Daid 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
You n ca You r
ts a different tax rate, please state ...............,..............;,::.:::.:.:.:,.:,::,;,:.: ~.:.:......,,, . .... e~4; ...,..::r.
------+~+~+-•~---~- ..... ,;;• .. _.,
..............
............~:::~~:
::,
~ :
~
~
relationshi to deco
,.,
;
:
~ :
r
:a ......
:a4'':~~_~•:+:~:_~'+::::~ ~'•~:~~~'•B=~~iS
............... - ._..... 3...r..........
TAX RETURN - COMPUTATION
LiN~ i. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
IUTAL center on Line 5 of Tax Computation) $
Under penalties of perjury, I cla a that a facts I have reported above are true, correct and
compl the best of kno dge belief HOME C7/~J )~~p _~`7~L~~
WORK (~/~ ) ~ ~~5~ ~ ~-r-,~
~A . ~ r~ss~~> :~~~ ~w_ _ _.
.,,E ~~~ "a `{
~` ~:
t`~ ~ ''
~i
~~~ ~
'~~ ~ ~ y~.
~ a
~. r ~ ~
~~
~r ~ {
~.
a r:
y~ ?~.\
'J .'
~. .
r~ "~
~'
~.
~f" TM
e+:R\
~ t~?x. ~
.`~ ,
E ~ ~~~
o
es
cw
~.
~~
~•4
ti~'~
4~t
`~ \ ;'ts
;~S
:^'1
..~3