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BUREAU OF INDIVIOUAL TAXES Pennsylvania lnheritance Tax � pennsylvania
PO BOX 280601 DEPARTMENTOFREVENUE
HARRISBURG PR 17128-0601 Information Notice �
xEV-�s<3 eR ee.exee �oe-ix�
And Taxpayer Response
FILENO.21 -13-�g(�j
ACN 13134302
DATE 06-25-2013
Type of Account
Estate of WILLARD BOWLBY Savings
SSN Checking
Date of Death 06-03-2013 Trust
LINDA J MCMASTER CountyCUMBERLAND Certificate
70 GREENFIELD DR � �;.; � m
CARLISLE PA 1�015-7682 � � m �
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MEMBERS isr vcu provided the department with the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
RemR Payment and Forms to:
Account No.252602
Date Established 09-15-2008 REGISTER OF WILLS
Account Balance $108,556.43 1 COUHTHOUSE S(�UARE
CARLISLE PA 17013
Percent Taxable X 16.667
Amount Subject to Tax $18,093.10
Tax Rate X 0.045 NOTE': If tax payments are made within three months of the
Potential Tau Due $814.19 decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tau x 0.95) $(see NOTE') 77�, y�I due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
�
A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on 2verse. Do not check any other boxes and disregard the amount
shown above as Potential Tar Due.
g �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right, and complete Part � �p�o I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none). �
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this lorm.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tau
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished. �Y
COMMONWEALTH OF PENNSVLVANIA REV-7762 EX�11-98)
DEPARTMENT QF REVENUE
BUREAU OF INDIVICILIAL TAXES
DEPT.28fl80t
HAqRIS9UFG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE ANp ESTATE TAX
, 4FFICIAt RECEtPT
NO. CD 01 ?903
SNY�ER WILLIRM V
40 BRlARW00D LANE
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CONTRO�
Nt1MBER
----° to� -------- -----
13134302� ( �773.48
ESTATE INFORMATION: sSN: (
FILE NUMBER: 2113-0686 �
DECEDENT NAME: BQWLBY WILLARD F �
DATE4FPAYMENT: 07f19J2013 �
PQSTMARK DATE: 07117/2C?13 �
CouNTY: CUMBERLAND (
pATE OF DEATH: (76j03j2073 �
�
TOTAL AMOUNT PAID: 5773.4$
REMARKS: Wl�LIAM V SNYDER JR
CHECK# 104
INITIALS: DB1
sEA�. FtEGEIVED BY: G�ENDA FARNER STRASBAUGH
REGISTER OF WiILS
RE4ISTER OF WILLS
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