HomeMy WebLinkAbout11-17-10 (2)DUREAU OF INDIVIDUAL TAXES
PD DOX 211601
RARRI{DURC PA 17126-0601
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~'~_',,~~;~~C~` 1d'EN°kSYLVANIA INHERITANCE T
INFORMATION NOTICE
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TAXPAYER RESPONSE
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FILE N0. 2i 10-0380
ACN 10161419
DATE 10-28-2010
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CUMBERLA~~D CO., PA,
HELEN SHRAWDER
63 LITTLE RUN RD
CAMP HILL PA 17011-2046
EST. OF HENRY L SHRAWDER
SSN 192-14-6434
DATE OF DEATH 03-26-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TOs
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
E OF ACCOUNT
SAVINGS
® CHECKIHB
TRUST
CERTLF.
SOVEREIGN SANK proridad the Departaent with the inforeution below, which bas bean used inn kalquletlna the
potantiel tax dw. Records indieab that at tM dwth of the abovrneud decedent, You wore a ioint owmr/Mngfiafa o~ this account.
If Yeu foal the inforaation is incorrect, please obtain written eorroetion fray the firtanoisl institution, attaoh II opY to this fora
and return it to the above address. This account is taxable in aecordann with the Inheritane• Tax laws ai the Cuba nwaalth of
Pennsylwnia. Plgsa call (7171 7a7-a327 witb qulstions. j
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 2331053839 Dat• 03-17-2004 To ensure proper credit to t a agcountr two
Estsbiishsd copies of this notice east coaparar
naaraant to the Rapiatar of;' k 21s. Meka ehaeds
Account Balane• 89, 056.52 payable to "Rapistar of Ni',ll ~s. A{ant".
Parcont Taxabi• X 50.000 ~ I
A~aount Sub~oet to Tax
~
44,528.26 NOTES If tex psyrants arej
aonths of the deeedent'a 4e ~da within three
of dnth,
Tax Rat• X . 15 deduct a 5 percent discousMt n ~M bx dw.
ArO, Inheritsnee Tax due wt~l bagoaa deiinquont
Potential Tax Duo $ 6,679.24 nine months after the detrt f death.
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neT~ parn aavcG
nscrurprtnu
AMOUNT PAID
TOTAL tEnter on Lin• 5 of Tax Computation) i i i
llndor penalties of porsury, L dociare that the facts I have reported sbov• ars true, coh
coeplet• to the~st of ey knowlod9• and belief. HOME C 3
I •ct and
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER A~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT.280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
SHRAWDER HELEN
63 LITTLE RUN ROAD
CAMP HILL, PA 1701 1
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REV-1162 EX(i t-961
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 1 s2-14-6434
FILE NUMBER: 2110-0380
DECEDENT NAME: SHRAWDER HENRY L
DATE OF PAYMENT: 1 1 / 17/2010
POSTMARK DATE: 1 1 /16/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 03/26/2010
ACN
ASSESSMENT
CONTROL
NUMBER
NO. CC~- 013661
AMOUNT
10161419 ~ ~ 5390.00
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TOTAL AMOUNT PAID: ~ 5390.00
REMARKS:
CHECK#1547
INITIALS: SAP
SEAL RECEIVED BY: GLENDA EARNER S~'RASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS