HomeMy WebLinkAbout09-18-08COMMONWEALTH 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 EXI11-961
NO. CD 010285
MADIGAN-SEDOR HELEN A
15501 WHITE WILLOW LANE
ROCKVILLE, MD 20853
fold
ESTATE INFORMATION: SSN: is1-34-2oas
FILE NUMBER: 2108-0744
DECEDENT NAME: LANTZY LOTS M
DATE OF PAYMENT: 09/ 1 8/2008
POSTMARK DATE: 09/16/2008
CouNTY: CUMBERLAND
DATE OF DEATH: 07/03/2008
' ACN
ASSESSMENT AMOUNT
jCONTROL
(NUMBER
018501116 ~ $774.41
I
I'
III
~~
II
~~
TOTAL AMOUNT PAIID: 5774.41
REMARKS:
CHECK# 1 194 '
INITIALS: CJ
SEAL RECEIVED BY: ~iLENDA EARNER STRASBAUGH
~iEGISTER OF WILLS
II
REGISTER OF WILLS '
i
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES FILE N0. 21 08-0744
Po Box zao6ol -r - ' AND ACN 08501116
HARRISBURG PA rnza-o6ol TAXPAYER RESPONSE
- DATE 09-09-2008
'I-.._.." ~ ~ ,. _!__ 'REV-1543A AFP C7.00)
'~~~~ S~~' 18 P~~ ~~~ 2~
CUf~-: .. .._ ,
HELEN MADIGAN-SEDOR
15501 WHITE WILLOW LANE
ROCKVILLE MD 20853
TYPE OF ACCOUNT
EST. DF LOIS M LANTZY ^ SECURITY
S.S. (~10. 161-34-2046 X^ sEC ACCT
DATE OF DEATH 07-03-2008 ^ sTOCK
COUNT'~Y CUMBERLAND ^ BDNDs
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
WACHOVIA has provided the Department with the inftirmation 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 beneficiary of this asset.
If you feel this information is incorrect, please obtain written correction from khe transfer agent, attach a copy to this fora and
return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania.
Questions ^ay be answered by calling C717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR F,ILIN6 AND PAYMENT INSTRUCTIONS
Under penalties of perjury, I declare that the facts I halve reported above are true, correct and
o~plete to th ~ best of awlpdge and belief .
my kp H~(9ME C`~~ ~ ) ~~ ~ 6 ~/ ~ 4
~~~,c~~ c~- )
- ~~~.~- WORK C ) -1.5~~0 ~~
TAXPAYER SIGNA RE TELEPHONE NUMBER DATE
PART DEBTS AND DEDUCTIONIS C
DATE PAID PAYEE DESCRP~PTION AMOUNT PAID
~~
~~
~
~~
~.
~ ~
~.
~-
i.~• ~ - c4
,_~G~,
• ~'L ~J
~. <._) C ..Y .
'~ - Q~
s t: _, i=1
i~ l;.f LLi
~ L•-,
~ <~~ ~` (~
~ r j't1-1
~_~ (1. C^
V
t..r
-~ C~J
'~ F, ~ ,
~.~ ~ G ^'"
1 ~? 3
o
o;
ii 1 ~oD ~^:., tV ~ i
I
.~ ~3~. ~,
~~~~
...
'. x r
O o
r
~' O
r
~ ,~ 1
i
M
~~ ~
~ r~
~~ -
a ~.
~. ~ O `...
"`}
C f~ < ..
~~_-
cC [.`
U
O~
U
~~
~- ~,
~'
1