The URL can be used to link to this page

Home My WebLink About10-04-12COMMONWEALTH 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 REV-1162 EX~11-96) NO. CD 016591 ADELLA A WAUHOP 20 FRELINGHUYSEN ST BELVIDERE, NJ 07823 -------- fold ESTATE INFORMATION: SSN: 153-16-4575 FILE NUMBER: 211 1-0801 DECEDENT NAME: AMMERMAN HELEN O DATE OF PAYMENT: 10/04/2012 POSTMARK DATE: 10/02/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 06/09/201 1 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $95.04 TOTAL AMOUNT PAID: $95.04 CHECK# 91 12 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E NO. 21 11 - 0 $ 01 Po Box 280601 r` r~!~~ ~~a ~f E~' TAXPAYER RESPONSE ACN 12503925 HARRISBURG PA 17128-0601 ~~~„ft..' t~~._i,_. ~ , r~-,~, -r •~~' ~',+~L~ ~ DATE 09-28-2012 ~`~ i REV-; ~'S43A'lAkp ~~ 00) ~ . ~... TYPE OF ACCOUNT ~7a3~~ QC~' '-'4 ~~"~ I I ~ .3 ~ EST. OF HELEN O AMMERMAN ^ SECURITY S . S . NO . 153 - 16 - 4575 ^ sEC ACCT DATE OF DEATH 06-09-2011 ^ ~TOCK ~ftt~f ~~~~ ~l.~~i~ COUNTY CUMBERLAND ^ BONDS ~iYtL~~RE.~VQ ~~ ~ ~ REMIT PAYMENT AND FORMS T0: ADELLA A WAUHOP REGISTER OF WILLS 20 FRELINGHUYSEN ST 1 COURTHOUSE SQUARE BELVIDERE NJ 07823-2023 CARLISLE PA 17013 WELLS FARGO has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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. Questions may be answered by calling C717) 7B7-8327. COMPLETE PART 1 B-FLAW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3501761939 To insure proper credit to your account, two C2) copies of this notice must accompany your DOD Valuation 6,336.00 payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Percent Taxable X 33.333 NOTE: If tax payments are made within three Amount Subject to Tax 2 ~ 111 • 9$ (3) months of the decedent's date of death, Tax Rate X . 045 you may deduct a 5% discount of the tax due. Anv inheritance tax due will become delinquent Potential TaX Due 95 • 04 nine (9) months after the date of death. PART TAXPAYER RESPONSE FAIL'TIRE TO RESPOND_WILL. RESULT"IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE A. The above information and tax due is correct. You may choose to 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 you may 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 decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ^3 below. PART If you indicate a different tax rate, please state your OFFICIAL USE 'QNLY ^ AAF' relationship to decedent: PA DEPARTMENT'C)F REVENUE TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS~ PAD LINE 1. DOD Valuation 1 1 2. Percent Taxable 2 X 2 3_ Amount Subject to Tax 3 3 4. Debts and Deductions 4 - 4 5. Amount Taxable 5 5 6. Tax Rate 6 X 6 7. Tax Due 7 7 $, PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 5 Under penalties of perjury, I declare that the facts I have reported~/above~7are true/,,correct and complete to the st of m knoy~rledge and belief . HOME C ' ~2S ) ` ~ y ~V~~ TAXPAYER SIGNATURE TELEPHONE NUMBER ATE ~. N ~ O ~• ~ ~ p„ ~o ~.' ~--~ ~.t ~'' ~y CD ~ ,--~ z~ ~ o~ ~~ N ~ `C W '"r N C N w i •. { 's , t £:~1 iii ;i ~ss ~:i iIi SSA ` \ ~~ 1v V 3 l ~ ~. t r~ ,~' ~\A`\~ V V , E1.7 ~"~ i rZ ~ ~_ ~~ ,~ ----` -~ '~ '-1 r• -- C11 ~~ ...~ ~,. ~ ,.-;•. 1 ;~y f'~ ~,~ti ~ a~~- \ : }~ r` :.f; a ~~ i f - fT F f s ?' ~~ €' s ~ r H ~., ~ ? ~ £ ~ ~ ~ ?~ Y ~, ~ ~ USA F'. FYST-C'LA~F~ FS!F