HomeMy WebLinkAbout04-20-09 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
BODTORF KARL
302 W MAIN
TAYOLRS, SC 29687
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN:
FILE NUMBER: 2108-1 181
DECEDENT NAME: BODTORF MABEL D
DATE OF PAYMENT: 04/20/2009
POSTMARK DATE: 04/17/2009
couNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 9/2008
REV-1162 EX111-96)
N0. CD 01 1 134
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09117124 ~ 525.14
TOTAL AMOUNT PAID:
REMARKS:
525.14
CHECK#140
INITIALS: CJ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE ND. 21 08-11$1
PD Box zeo6ol ~ T~p~AY~I~ sI~ESPONSE ACN 09117124
HARRISBURG PA 17128-0601 p
REV-1543 EX I1FP COB-0e) ~ '~~~ ~''~ "- DATE 03-18-2009
TYPE OF ACCOUNT
~C'~ ~~~ 20 ~~~r~ ~F MABEL D BODTORF ^ SAVINGS
Karl R. Bodtorf, P.C.
SSN
^ CHECKING
302 West Main Street CLERK CF DATE OF DEATH 11-19-2008 ^ TRUST
Taylors, SC 29687 QRPHI~N'c COIUNTY CUMBERLAND O CERTIF.
t
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\YViViFJ~~~~ ~`4~ ~~~~~ PAYMENT AND FORMS T0:
KARL BODTORF REGISTER OF WILLS
203 W M N ST CUMBERLAND CO COURT HOUSE
TAYLOR SC 29687 CARLISLE, PA 17013
FULTON 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 ioint 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
Pennayivanie. Plrase cell <717) 787-Sb27 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 251-0 051731 Date 08-01-1986 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 1 , 117 .41 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax g 558.71 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 $ 25.14 nine months after the date of death.
PART TAXPAYER RESPONSE
E ~ ,~i ._
A. ~ The 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
CHECK Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
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 Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
DEBTS AND DEDUCTIONS CLAIMED
TOTAL (Enter on Line 5 of Tax Computation) ~
Under penalties of perjury, I declare that the facts I have reported above are true, correct and /'y
complete to the best of my knowledge and belief. HOME C ) `',
WORK C ) (~f(
TA AYER SIGNATURE TELEPHONE NUMBER DATE
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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