HomeMy WebLinkAbout04-14-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0801
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1182 EX111-981
N0. CD 01 1 107
WIGGINGTON JUDY S
13 HAXELWOOD PATH
MECHANICSBURG, PA 17050
role
ESTATE INFORMATION: SSN: 20403-8758
FILE NUMBER: 2109-0306
DECEDENT NAME: COSH ROBERT A
DATE OF PAYMENT: 04/14/2009
POSTMARK DATE: 04/13/2009
couNTY: CUMBERLAND
DATE OF DEATH: 02/23/2009
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09117945 ~ 538.24
TOTAL AMOUNT PAID:
REMARKS: JUDY S WIGGINGTON
CHECK# 6466
SEAL
INITIALS: WZ
RECEIVED BY
538.24
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
WIRRISBUR6 PA 17128-0601
mvaaes a rr ua-on
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
-~;~E_n ~,:--~(', ~; AND
;~,•,'~~~XI~k~ER RESPONSE
.7ir]Ttri V, iL....
FILE N0. 21~- O / ' U30C~
ACN 09117945
DATE 03-23-2009
2409 APR t 4 AM 111 12
EST. OF R08ERT A LOSH
CLERK OF ssN 204-03-6756
ORPt1AN~S COURT DATE OF DEATH 02-23-2009
ryry,~ CRS :a°~G CO,.COUNTY CUMBERLAND
l+VM1`~. ~ ~~~ ~ REMIT PAYMENT AND FORMS T0:
JUDY S WIGGINGTON REGISTER OF WILLS
13 HAZELWOOD PATH CUMBERLAND CO COURT HOUSE
MECHANICSBURG PA 17050-9155 CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRU57
CERTIF.
PNC BANK NA provid+tl the Oepartmant with tho informatlen bola:, which has boon usatl Sn ealeulstinp the
potantisl tax duo. R+corda indieata that at tho da+th of the abov+-nomad deeatlant, you ware a !Dint owner/ban+fieiary of this account.
If you foal the informat Lon is incorraet, plassa obtain written eorraetion free tea financial institution, attach a copy to this fora
sntl rata rn it to the above addr+aa. This seeount is taxsbl• in aeco rtlsnea with th+ Inheritance Tax lava of the Coaonwealth of
Penn sylrania. Plasae call (7177 787-BS27 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005140038863 Omt• 01-01-1978 To ansura proper er+dit to the account. twe
Established eepios of this notiea oust aeeemparo
Account Balane• $ 2, 020.91 pavan( to th+ Rapiahr of Willa. Make eh+ck
paysbla to "R+pisL+r of Wills, Ap+nt".
Pmrcant Taxable X 50.000
Aaoun! Subloet to Taz g 1,010.46 NOTE: If ksz peymants era made within thraa
menthe of the daeadont'a data of duth,
Tax Rato ~( , lij daduet a 5 pareanY discount on Lh+ tax duo.
Potential Tax Duo $ 151 .57 Am Inheritane+ Taz due will boeoma delinquent
nim months sfter 4he tlate of tlpth.
P~r TAXPAYER RESPONS
1
A. ~ The sbov+ information sntl t+x tlue is eornct. -
R+mit p+ymant !o the Repiatar of WSlla with two eopiea of this notiea to obtain
CHECK + tliacaunt or avoid interest, or eh+ek box "A" and return this notice to the Register of
ONE ~ Wills sntl an official sasesamt will be issued by the PA Departunt of Revanu+.
BLOCK 0. ~ The shove asset has been er will be reported and tax p+1d with the P+nnsvlvenia Inheritance Tsx return
ONL Y IIIOOOIII to be filed by the eatste representative.
C. ~ Tha above infer a !en is incorraet snd/or deb to mtl tlaductiom ware paitl.
Cempl eta PART ~2 anNOr PART 3~ bel ar.
PAZRT IT intlicatin9 a dtfforont tax~~~~ la~~ gtat•
relationship Lo tloeetlont: !f /t
TAX RETURN - COMPUTATION OF TAX ON J/OINT/TRhUST ACCOUNTS
LINE 1. Date EstaDll ahetl 1 // ~/ ~Q ! (~
2. Account Balance 2. S 21 O1-0~-
e
3. Portent Tmxabla 3 X Kpr00
4. Amount Subject to Tax 4- ~ ~ O 16 ~~
5. Dohts and Daduetlons 5 II I ~o ~O~
6. Amount TaxabU 0 Z p Q~~,~,~
7. Tax Rato 7 x e • OIF,S"
e. Tax Dw a = -1 -~ 4: ~. ,~ _ 2I[
PART IND1T! Aif• OtDUCTIMfi CLA]
0
DATE PAID PAYEE DESCRTpr7oN
+unuur Warn
wnger pen+ic AOS or poryury. ! tloclaro that M• fseta I have npo rtetl aDow ors true, correct sntl
eomplot•nto th• host of ny knowletlps sntl boliaf. HOME C / ) 3J.-.5'6 6 ,6
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