HomeMy WebLinkAbout05-11-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1182 EX111-981
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARgISBURG, PA 11128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 01 1215
DUPLICATE
STORM TATYANA
504 HUMMEL AVENUE
LEMOYNE, PA 17043
ACN
ASSESSMENT AMOUNT
CONTROL
,pld NUMBER
REMARKS: TATYANA V STORM
CHECK#1648
SEAL
09124523 ~ 568.75
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
568.75
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
BUREAU Of INDIVIDUAL TAXES AND
NARK Im3aUR66PA vise-OSpI TAXPAYER RESPONSE
xavaaas a err roe-au
2004 na r i i f
CLERK (,
O~iPHAN'S GC
TATYANA STROM ~'_~~iB~RLaAdC ~-
504 HUMMEL AVENUE
LEMOYNE PA 17043
FILE N0. 21 - ~-/ -~~
ACN 09124523
DATE 04-15-2009
EST. OF NEIL L STROM
SSN 396-46-7930
DATE OF DEATH 03-26-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD;
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU provided the Depa rtnan4 with the informatipn below, which has bean used in calculating the
potential 4ax due. Records indicate that at the death of 4ha above-named deeeden t, you ware a joint owner/beneficia rv of this account.
If you feel the inf ore ation is incarre ck, please obtain written correction Fran 4ha financial institution, attach a copy to this fora
end return it to the above atld ress. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Penn svlvania. Please call [717) 787-8327 with euastion s.
COMPLETE PART 1 BELOW r SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 112681-11 Date 10-18-7nnn
Account Balance
Percent Taxable
Amount Subj act to Tax
Tax Rate
Potential Tax Due
Establlshetl
S 916.59
X 50.000
S 458.30
X .15
$ 68.75
3. Percent Taxable ; X
4. Amount Suhject to Tax 4 $
5. Oehts antl Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
e. Tax Due g $
PART
DATE PAID PAYEE
To ensure proper credit to Oho account, two
copies of this notice musk aecompara'
pavmenk to the Register of Wills. Mak• chock
payable to "Resister of Wills. Agent".
NOTE: If tax pavmen is are made within three
months of the decedent's data of death,
deduct a 5 pa rcenk discount on the tax due.
Arty Inheritance lax due will become del3nouent
nine nonths of tar the data of daakh.
DESCRIPTION
CEnter on Line 5 0
AMOUNT PAID
Under penaltl es
eompl a to the of perjury, I declare that the facts I
best of m
k have reported above era true, correct and
~~I'Q y
nowledge and belief.
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