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Home My WebLink About11-23-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: STEIGERWALT MICHAEL L 3609 KOHLER PLACE APT 15 CAMP HILL, PA 1701 1 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssrv: 15s-~ 8-s8sa FILE NUMBER: 2110-1 1 13 DECEDENT NAME: STEIGERWALT CLAUD H DATE OF PAYMENT: 1 1 / 23/ 2010 POSTMARK DATE: 1 1 /23/2010 COUNTY: CUMBERLAND DATE OF DEATH: 09/22/2010 ACN ASSESSMENT CONTROL NUMBER AMOUNT 10158607 ~ 5866.88 TOTAL AMOUNT PAID: REMARKS: CHECK# 465 SEAL INITIALS: CJ RECEIVED BY: 5866.88 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 013693 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 'PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND ~~'~'` ~' ,'I_'-('F/~-PAYER RESPONSE - - ~''~ ,~~ r ., . ~jy4 C REV-1543 E% "`~~w~}!1 ~ y ~ ~'4~1 ~ {, „' j T FILE N0.21`~~~''III~ ACN 10158607 DATE 10-14-2010 210 NOY 23 PH 12~ 44 CLERK ~F 4RPNAN'~ COURT GUM°=~~ ~~~ r± ~ , P~~ MICHAEL L STEIGERWALT APT 15 3609 KOHLER PL CAMP HILL PA 17011-2766 EST. OF CLAUD H STEIGERWALT SSN 159-18-6894 DATE OF DEATH 09-22-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PSECU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decedent, you were a ioint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance_T~x laws of the Cowwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0159186894-S7 Date 07-06-2004 To ensure proper credit to the account, two Established copies of this notice ^ust accowpany 3 8 2.6 2 paywent to the Register of Wills. Make check Account Balance $ 5 4 , payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax paywents are wade within three Amount Subject t0 Tax $ 27 ~ 191.31 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 becowe delinquent Potential Tax Due ~` 1 ~ 223.61 nine wonths after the date of death. PART TAXPAYER RESPONSE J4~t.~il~~-~`'t!'RESP,~i~'3;~#1I i.:~, U~~-: rA~t C4FfI~:IAt,~'A~'t~&, A. ~ The above inforwation and tax due is correct. Rewit paywent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assesswent will be issued by the PA Departwent of Revenue. C ONE BLOCK 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 inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state a ~.-°• relationship to decedent: rii. ~ 2 ~,~~~ ~ ~ TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS p~"„ LINE 1 . Date Established 1 (~ "~ ' O ~o ' X00 ~ `~ ~~. 2. Account Balance 2 $ 3~4: 3$ Z •~Z ~„ 3. Percent Taxable 3 X ~ O • Oa n 4 t; , ~ ,,.,, 4. Amount Subject to Tax 4 $ Z T~ 1 g. 1. 3 ( ~~,;;., 5. Debts and Deductions 5 - q 1 3 - SZ Ce i '' ~`'`~~«~... 6. Amount Taxable 6 $ ~ ~ , ~ ~ 7 • `~9 _. ~~ 7. Tax Rate 7 X ~ ' S~ ~ ~,;» 8. Tax Due g ~ 1 2, D '~ `~'~ ~w....:.,:~._. i~'•4 w / - PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above areQQtrue, correct and compl~e tQo t e b st of my knowled d belief. HOME ( ~ ~~ ) _`7~ ~3S S `~ ~~-}-`~c/` ~ ~ WORK C ) 1 •~'Z.~ I e~~ T AYDAVCD CTGNATIIRF TFI FPHONE NUMBER DATE' pia-,S~-`~. ~Q: ~~w_ 1~- DEBTS and DEDUCTIONS Date Paid Payee Description 09/24/10 Sue Sohn Health Aide prior to death 09/27/10 USAA July credit card 09/27/10 Verizon Sep phone 09/27/10 Comcast Sep cable 09/27/10 PPL Sep electric 09/28/10 Joy Scotti Health Aide prior to death 09/28/10 Parthamore Funeral Expense 09/30/10 Griswold Health Aide Company 10/01/10 L. Brechi Health Aide prior to death 10/04/10 PMI Apartment Rent (2 mo notice) 10/07/10 Griswald Health Aide Company 10/09/10 Preacher Eulogy 10/09/10 83 Diner Funeral Meal 10/13/10 C. Foose Health Aide prior to death 10/25/10 Olivet Cemetery digging fee 10/28/10 USAA August credit card 11/04/10 PMI Apartment Rent (2 mo notice) Total Amount Paid $70.50 $56.17 $61.67 $62.76 $120.22 $129.25 $3,120.00 $204.80 $258.50 $760.00 $127.00 $50.00 $213.00 $139.00 $750.00 $30.65 $760.00 $6,913.52 Page 1