HomeMy WebLinkAbout04-20-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EXI11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 2F30601
HARRISEURG, PA 17126-0601
RECEIVED FROM: PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 01 1 131
ZOOIK BETTE J
24 GUNPOWDER ROAD
MECIHANICSBURG, PA 17050
ACN
ASSESSMENT AMOUNT
CONTROL
------ fold NUMBER
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTORNEY
CHECK# 1010
INITIALS: AJW
SEAL RECEIVED BY:
$12.58
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 ~~1 ~°JJI
BUREAU OF :[NDIVIDUAL TAXES
Po Box zao~ol
TAXPAYER RESPONSE
ACN
09100571
HARRISBURG PA 17128-0601 DATE 01-02- 2009
REV-1543 E% AFP COB-OB)
TYPE OF ACCOUNT
EST. OF VIVIAN R DAWSON ^ SAVINGS
SSN 188-12-4380 ® CHECKING
DATE OF DEATH 09-21-20~ r~
~ ^ TRUST
COUNTY CUMBERLAND ~~ ~ ~-LER'fIF.
REMIT PAYMENT AND FORMS T0: ~~ _ ~
~ ~
CHARLES H DAWSON -~ ~~~
REGISTER OF WILLS
' N -
7 N BALTIMORE ST ~.Ec,,~~
CUMBERLAND CO COURT HOU p
PO BOX 122 CARLISLE, PA 17013 r=,~ 7~ '~ _
FRANKLINTOWN PA 17323 t--}
-n ~ _
~ _ ..
D~ ~ _ _
C?
M&T BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, You were a point owner/beneficiary of this account.
If you feel the 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
Fenrsylvania. Pleasa call (7171 787-8327 witF. questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 27623858 Date 05-24-2004 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance $ 3, 354.65 payable to "Register of Wills, Agent".
Percent Taxable X 8.333
NDTE: If tax payments are made within three
Amount Subject to Tax $ 279 • 54 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 12 • 58 nine months after the date of death.
PART TAXPAYER RESPONSE
D .;A,ILURE Tfl R~SPQND WILL RESILT IN AN ~FICIAt~ TAX ~ ~ NT
The
A above information and tax due is correct.
.~ Remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid i nterest, or 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.
ONE
C
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 estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account 5alance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
pFF IC I~„33SILY
PA DEPARTMENT' OF REVENUE
OF TAX ON JOINT/TRUST ACCOUNTS PAD "'~'
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2
3 X
4
5
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7 X
8
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2
3
4
5
6
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DEBTS AND DEDUCTIONS CLAIMED
PART
...~~ ~..., oevGF DESCRIPTION
AMOUNT PAID
IVINL lCll~c,
Under penalties of perjury, I declare that the facts I have reported ab`ov^~e are//true, correct and
mplete to the best of my knowledge and belief. HOME C~! t ~ `-t ~Z ~~~Z
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