HomeMy WebLinkAbout11-08-10 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
STEIGERWALT MICHAEL L
3609 KOHLER PLACE APT 15
CAMP HILL, PA 1701 1
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV 1 162 EX(11 -96)
NO. CD 013617
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: ssrv: ~ 59-~ s-6s94
FILE NUMBER: 2110-1 1 13
DECEDENT NAME: STEIGERWALT CLAUD H
DATE OF PAYMENT: 1 1 /08/2010
POSTMARK DATE: 1 1 /05/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 09/ 22/ 2010
10160630 ~ 5215.73
TOTAL AMOUNT PAID:
REMARKS: MICHAEL L STEIGERWALT
CHECK# 5218
SEAL
INITIALS: WZ
5215.73
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITid-NCE 'TAX
INIFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES _" ~'~~~ r ~ ~ - AND
Po Box z8o6o1 ' ``~-~ ~~~~~ `~~ TAXPAYER RESPONSE
HARRISBURG PA 17128-0601 ~-~
~ ~ ,.
REV-1543 EX AFP (OB-08)
FILE N0. 21 ~l` ~~~ ~~
ACN 10160630
DATE 10-25-2010
~0 ~ Q tiQY -8 P~ 2~ d ~
CLERK ~~
OFPN~SJ'S ~'~~~.l~T
G1~t~~~~F~' ~~:~,'~'~ ~~ PA
MICHAEL L STEIGERWALT
3609 KOHLER PL APT 15
CAMP HILL PA 17011-2765
EST. OF CLAUD H STEIGERWALT
SSN 159-18-6894
DATE OF DEATH 09-22-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information below, which has 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 17173 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005140061721 Date 10-20-2003 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 10 ~ 092.60 payment to the Register of Wills. Make check
payable to Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 5, 046.30 months of the decedent's date of death,
Tax Rate )( .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due ~` 227.08 nine months after the date of death.
PART TAXPAYER RESPONSE
1^
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT.
A. ^ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
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 informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF'
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due g $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMnIiNT PATT1
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
compete t the__~est of m I
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I ~.aowledge and belief . HOME ( 7 ~ Z ) ~'? S - ~ `~S ~'
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TAXPAYER IGNAT
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