HomeMy WebLinkAbout10-07-08 (5)COMMONWEALTH OF PENNSYLVANIA ~~~-3N~~'R.~A ~ND NOTICE
DEPARTMENT OF REVENUE ` ., „ , `~
BUREAU OF INDIVIDUAL TAXES
DEPT. 266661 TAXPAYER RESPONSE
HARRISBURG, PA 17128-0661 ~•~ "
REV-1543 E% RFP (09-DD)
ACN 08133802
DATE 07-24-2008
^_ n ~ i
EST. OF JOSEPH G SEMANCIK
~i~ ~ S.S. N0. 188-38-9627
~_,, ~~ OF DEATH 07-12-2008
~ ~ `' _ ~tjU ~y CUMBERLAND
~"~~ ~.
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
~ .; .
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CHRISTOPH J SEMANCIK CUMBERLAND CO COURT HOUSE
4943 WATERFALL DRPA 18062 CARLISLE, PA 17013
MACUNGIE
HARLEYSVILLE NB 8 TC has provided the Department with the information listed below which has been used in
thisuaccountthIf pv ounf eel thisdinf ormationeisrincorr ec{tepleaseaobtaindw ritten correctiondfromethe financialainstit,ution ,~/attachcaacopYf
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax L<-iws 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 INS"fRUCTIONS
Account No. 20013005 Date 03-04-1992 To insure proper credit to your account, two
C2) copies of this notice Rust accompany your
Established payment to the Register of Wills. Make check
ACCOUnt Balance 2, 753 95 payable to: "Register of Wills, Agent".
X 1 6 .6 6 7 NOTE: If tax payments are made within three
Percent Taxable
Amount Subject t0 TaX 459.00 (3) months of the decedent's date of death.
• 1 5 you may deduct a 5% discount of the tax due.
Tax Rate X Anv inheritance tax due will become delinquent
Potential Tax Due 68 • 85 nine C9) months after the date of death.
TAXPAYER RESPONSE
T :::::::
AR
P
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 "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
B L 0 C K B. ~ toebebfiledsbytthesdecedent's1reD esentative,and tax paid with the Pennsylvania Inheritance Tax return
ONLY
C, IYI The above information is incorrect and/or debts and deductions were paid by You.
~4 You must complete PART ~ and/or PART ~ below.
PART If you indicate a different tax rat ~ phase state your
2 relationship to decedent: ~'~'~~''
JOIN /TRUST ACCOUNTS !~~`~~~a
TAX RETURN - COMPUTATION OF TAX 0~~ ~, j~~,~~y .' ~;,;,'
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) 8
Under penalties of perjury, I declare that the facts I have reported above are tryyu``e, correct and
compl e t the t of my knowledge and belief. HOME ~ ~~~ ~ `~~ 7 UO ~~ _
WORK C ) ~c~S-- Ck~
- ___ TELEPHONE NUMBER DAT
R IGNA
COMMONWEALTH OF PENNSYLVANIA
DEPf~'.4-6F REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
SEMANCIK CHRISOPHER
4943 WATERFALL DRIVE
MACUNGIE, PA 18062
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-961
NO. CD 010380
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: SSty: 18s-38-9627
FILE NUMBER: 2108-1002
DECEDENT NAME: SEMANCIK JOSEPH G
DATE OF PAYMENT: 10/07/2008
POSTMARK DATE: 10/06/2008
COUNTY: CUMBERLAND "
DATE OF DEATH: 07/12/2008
08133802 ~ 519.63
TOTAL AMOUNT PAID:
REMARKS: CHRISTOPHER SEMANCIK
CHECK# 9106
519.63
INITIALS: WZ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
1
_~
i
i
1
i
f
S
i
t
i
~•
9
,,: ~°:~
it a+~
~~„
a~
r~i
i
~ '~
~~
~,
~ ~'
r ~ \
(~1--
(/)
~`i
7 +`~~ 1 •
v 1
~.
,,.,~„
l_~ _i: - _
'
„ ~~ 1 - -
' .~;j
.~
V , ~
~~ ~ r
~J
J
-~~
~
~~ ~.
--
. __
1
~
~
i:~.~
1•~•i
` j',1
~ti
- ~ ~ ~~/ .~.
•rd
.-. ~ i.. t