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HomeMy WebLinkAbout11-23-10 (2)COMMONWEALTH 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 NO. CD 013692 STEIGERWALT MICHAEL L 3609 KOHLER PLACE APT 15 CAMP HILL, PA 17011 fold ESTATE INFORMATION: SSN: X59-7s-6894 FILE NUMBER: 2110-1 1 13 DECEDENT NAME: STEIGERWALT CLAUD H DATE OF PAYMENT: 1 1 /23/2010 POSTMARK DATE: 1 1 /22/2010 COUNTY: CUMBERLAND DATE OF DEATH: 09/22/2010 REMARKS: CHECK# 464 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 10158606 ~ 597.38 TOTAL AMOUNT PAID: INITIALS: CJ REV-1162 EX111-96) 597.38 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS - PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE //~~ BUREAU OF INDIVIDUAL TAXES j f' ~li~~. ~~= AND F I L E NO . 21 ~'I V ' ~ I Po Box zao6ol ,,, } c~ TAXPAYER RESPONSE ACN 10158606 HARRISBURG PA 17126-0601 r '~~ ,~ ~ y{..r, L7 vLC~ `~'' DATE 10-14-2010 REV-I54 ~E% 8FP (Re-08) 2010 HOV 23 PM 12~ 39 CLERK OF ORPHAN'S, CUtJRT 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 point 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 Tax laws of the Cowwonwealth of Pennsylvania. Rlease-cell C7i7) 787-8323 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0159186894-S4 Date 07-09-1985 Account Balance Established $ 4,555.35 To ensure proper credit to the account, two copies of this notice ^ust accowpany paywent to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax paywents are wade within three AmOUnt Subject to Tax ~ 2,277.68 wonths of the decedent's date of death, Tax Rate ~( , 04rj deduct a 5 percent discount on the tax due. Aron Inheritance Tax due will becowe delinquent Potential Tax Due $ 102.50 nine wonths after the date of death. PART TAXPAYER RESPONSE 1 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. 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 inforwa ion is incorrect and/or debts and deductions were paid. Cowplata 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 OF TAX ON JOINT/TRUST ACCOUNTS `p °'~k"' fir.::-~` ~i ri, ~,.. ', J • ...., .LLy ~ * 3 X ' '~ r~ ~ ~ ~[ ~ '3 }} y $ ~ ~-~,.YA.-..f ,Mll ~ r. ~ ~~~~~ ~~~ •+..rrw~,.wM1rwe ~~( . I ~ '~" TMw~..MgMiy~~...n iY ,p--w+~- r ~~°~~i~l~~''~'ti~}~' cw -' I ~~~~yi r........... r."L......- '_ ~' 5 - ahi" ~ ., ~~d:~`~~_t~'~,fq~4~p~}i~ y - 3 4 t' iW i,~~,.2xj~~~ r a ," ,1 '~ ~ ~ 7 X ~, ,.~,, --. PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are©true, correct and comp e e be of my knowle and belief. HOME C-?\"? ) i 7~ ~SSe _ WORK C ) ~ l 1~ 20 d ,YPAYFR CTRNA~TIIRF TFI FP41f1NG NIIMAFD wT TOTAL CEnter on Line 5 of Tax Computation) t ,___.. j ..~ ~,-a. ~., ~~--~~,., z,- ~ ,- 2Q10 NOY 23 PM 12= 35 tny~~. t ~/' w rh~~{n' i ~ fry.~q '. .. ~,li I'~ ~V„ r CUMBERIAND CO , PA M ,, ,,. .D `"' .. r r ... *~' / [ /' .J i . ~ ,. ... 3 .~ ~ ! v ~ ~, ~ '' Q #!1 ,. t7 r. ;N J o ;" 3 c ~~, ~~ ~~.: r+ ~~ -k J