HomeMy WebLinkAbout05-06-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
LAMP SHARON
101 MAPLE DRIVE
MECHANICSBURG, PA 17050
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ESTATE INFORMATION: ssN: 575-22-8144
FILE NUMBER: 2109-0431
DECEDENT NAME: LAMP MILDRED O
DATE OF PAYMENT: 05/06/2009
POSTMARK DATE: 05/05/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 03/27/2009
AMOUNT
ACN
ASSESSMENT
CONTROL
NUMBER
09125532 ~ 5653.22
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1 130
SEAL
5653.22
INITIALS: CJ
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX(11-96)
N0. CD 01 1 197
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~~yy~~,, /~
-- AND FILE N0. 21~(,J"~~~43i
BUREAU OF INDIVIDUAL TAXES ACN 09125532
Po Box zao6al TAXPAYER RESPONSE
HARRISBURG PA lnzB-o6g1 _ . DATE 04-20-2009
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SHARON L LAMP
101 MAPLE DR
MECHANICSBURG PA 17050-2726
EST. OF MILDRED 0 LAMP
SSN 575-2'e:-8144
DATE OF DEATH 03-27-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 170].3
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information below, which hers been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint 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
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005070097269 Date 05-07-1990 To ensure prc~ver credit to the account, two
Established copies of this notice oust accompany
M k h k
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
$ 9,165.76
X 50.000
$ 4,582.88
Y .15
PART
CHECK
ONE
[ BLOCK
ONLY
SPO
payment to thie Register of Wills. a e c ec
payable to "F;agister of Wills, Agent".
NOTE: If ta,: payments are made within three
months of the decedent's date of death,
deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
nine months after the date of death.
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 interest, or check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
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 3~ 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
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
DEBTS AND DEDUCTIONS CLAIMED
TOTAL CEnter on Line 5 or rax t,o mputativn,
Under penalties of perjury, I declare that the facts I have reported above re t~rue,~~/prrect and
comp t to the best my k owledge and belief . HOME C ~ I ) _ (l' ~/ ~ ~~
WORK C ~~~) ~ ~ C~ ~ ~(J 3 3
TAXPAYER SIGNATURE TELEPHONE NUMBER ' DATE ~•/ c,/-~j9'
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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