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HomeMy WebLinkAbout04-1194COMMONWEALTH OF PENNSYLVANIA DEPARTMENT DF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004779 NUGENT MARY ANN 10200 DAVENTRY RD COCKEYSVILLE, MD 21034 ........ fold ESTATE INFORMATION: SSN: 118-32-1866 FILE NUMBER: 2104- 1194 DECEDENT NAME: NUGENT BARBARA DATE OF PAYMENT: 12/30/2004 POSTMARK DATE: 1 2/30/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/07/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 t~360.00 TOTAL AMOUNT PAID: $360.00 REMARKS: SEAL CHECK//543 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 .t~ HARRISBURG, PA 17128-0601 0 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH {MM-DD-YEAR) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE ~NITIAL) FILE NUMBER ~ COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER - 32_ - _ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIALSECURITYNUMBER 4. Limited Estate []6. Decedent Died Testate (A~ach copy of Will) [~9. Liggafion Proceeds Received [~2. Supplemental Retam [~4a, Future Interest Compromise Idate of deah abe' 12-12,82) [~7. Decedent Maintained a Living Trust (A~h copy of Tm~g [~5. Federal Estate Tax Return Required 8, Total Number of Safe Deposit Boxes [] 11. Election to tax under Sec. 9113(A) (~ch Sch O) NAMEJo F FIRM NAME 0f Ap¢~ue} TELEPHONE NUMBER COMPLETE MAILING ADDRESS 1. Real Estate (Schedule A) (1) 2, Stocks and Bonds {Schedule B) (2) 3 Closely Held Corporation, Partnership or So~e-Pmp~etorship (3) 4. Mortgages & Notes Receivable {Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Pmbeta Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Admleistmtive Costa (Schedule H) (9) 10, Debts of Oecedent, Uodgage Ltabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13 Charitable and Govemmentai Bequests/Sec 9113 Tmsta for which an election to tax has not been made {Schedule J) 14, Net Value Subject to Tax (Line 12 minus Line 13) (11) ?-.Off, 0o0 (1~) 11.~ : (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x ,0 (15) x .o x .12 16 Amount of Line 14 taxable at lineal rate (16) 17. Amount of Line 14 taxable at sibling rate (17) 18. Amount of Line 14 taxable at co~tateral rate x .15 (18) 19, Tax Oue (19) Deced~nt's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Cradits (A + 8 + C ) 3. InterestJPenalty if app~iceble D. ~nterost E. Penalty Tota~ Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (1) I ZIP ~ '70 (2) (3) (4) (5) (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; .......................................................................................... [] b. retain the right to designate who shall use the properly transferred or its income', ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] d, receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death cccurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probafe property which contains a beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penal~es of perjurT, I declare that I have examined this ~m, including accompanying schedules and s~ataments, and to ~e best of my knowledge and belie fi it is Ime, correct and axnp~te. Dedara~n of preparer other than the personal representative is based on all thfoffna~on of which p~eparer has any knowledge. SIGNATURFz~F PERSON~ESPONSIBLE F~R FJJ. INGRETURN [ DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for th~ use of the surviving spouse is 3% (72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute dg(~s not exemot a transfer to a surviving spouse from tax, and the statutory rsquiraments for disclosure of assets and filing a tax ratum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after Jdy 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenfis lineal beneficiaries is 4.5%, except ss noted in 72 ES. §9116(1.2) ['/2 RS. §9116(a){1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under S~Uon 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 1, Recapitulation) $ ~--'~t ~) ' .¢._~_.~ (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (6-98~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G, SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOIN1 MADE INCLUDE NAME OF F~NANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECDS VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST TOTAL (Also enter on line 6, Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH VITAL RECORDS LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. T 5660084 Julv ~ 2. 2004 Name of Decedent Barbara Ann Nucr~n~-. Sex 'Female Social Security No. ~ ~ 8-32-1866 Date of Death --July 07, 2004 Date of Birth Nov. 25, ]94] Birthplace __ Q._u_eens_,_.~_N~'___ Place of Death M.S. HersheI Me~dical Center Dauphin Derr~L_~c~D_. Race White Occupation N~rse/Hospital Adr~/Medic~al Armed Forces? (Yes or No) Decedent's Marital Status Divorced Mailing Address 7~4 Veronica Lane Enola Informant MaryAnn Caskey Funeral Director Alfred B. Clauser Name and Address of Funeral Establishment Rob/and Funeral Home, Inc, 508 ~.r_.l___a. nd St, Lebanon, PA, Part I: Immediate Cause (a) Respiratory Failure (b) Aspirated (c) Fever of Unknown Origin (d) Pad I1: Other Significant Conditions Pennsylvania Yes ! 7042 Interval Between Onset and Death Manner of Death Natural ~J Homicide L~ Accident ~ Pending Investigation [] Suicide ~l Could not be Determined [-_-~ Describe how injury occurred: Name and Title of Certfier Erin Miller, DO Address M.S. Hershey Medical Center, Hershey, PA, ~7033 (M.D., D.C., Coroner, M.E.) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. July 08, 2004 !68~ Mill Rd, Lebanon, PA, 17042 dlb~deeds\nugent RECORDATION REQUESTED BY: Reager & Adler, PC 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 WHEN RECORDED MAIL TO: Barbara A. Nugent 714 Veronica Lane Enola, PA 17025 TAX PARCEL NO. 09-12-2992-253 SEND TAX NOTICES TO: Barbara A. Nugent 714 Veronica Lane Enola, PA 17025 · ,,~ ,,, ,~I~L~.R ...~,~.F, OF DEEDS ']EgLAND OOUNTY-=;, '03 JUN 20 Riff 11 06 SPACE ABOVE THIS LINE IS FOR RECORDER'S USE ONLY THIS DEED, Made the I'~'~t' day of June, 2003, BETWEEN BARBARA A. NUGENT, a single woman, hereinafter designated as the Grantor, AND BARBARA A. NUGENT, JOSEPH WILLIAM NUGENT and JENNIFER A. NUGENT, joint tenants with right of survivorship, hereinafter designated as the Grantees. WITNESSETH, that the Grantor for and in consideration of One Dollar ($1.00), lawful money of the United States of America, to the Grantor in hand well and truly paid by the Grantees, at or before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged and the Gramor being therewith fully satisfied, does by these presents grant, bargain, sell and convey unto the Grantees forever. ALL THAT CERTAIN lot or tract of land situate in East Pennsboro Township, Cumberland County, Commonwealth of Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at a point on the southern dedicated right-of-way line of Veronica Lane at the dividing line of Lots Nos. 87 and 88, said point also being located 296.20 feet west of the western extremity of an arc connecting the southern dedicated right-of-way line of Veronica Lane and the western dedicated right-of-way of Brisbain Lane; thence by line of Lot No. 87, South 22 degrees 26 minutes 01 second East, 105 feet to a point; thence by line of other lands of Westwood Hills, South 67 degrees 33 minutes 59 seconds West, 76.20 feet to a point at the dividing line of Lots Nos. 89 and 88; thence by Lot No. 89, North 22 degrees 26 minutes 01 second West, 105 feet to a point on the southern right-of-way line of Veronica Lane; thence by SUMMARY OF SALIENT FEATURES Subject Ntdmss 714 VERONICA LN Legal D~cr~p~n ATTACHED DEED 257-4361 Oily ENOLA COUlI~ CUMBERLAND State PA Z]p Code 17025-1554 Censm Tract 0102.01 Uap Rd~ SEE APN $~ price $ REFI Dm of Sale NIA ~orrow~*/Clle~ NUGENT,JOSEPH/JENNIFER Le~ler EXCEL MORTGAGE GROUP, INC. REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY , Deceased No. 20 04 01191 Date of Death 11/18/2004 Social Security No. 183362723 Estate of STELLA M CRUSE also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. l!We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: ey;J;;gyJJ RICHARD S RUBLE Oaled .-:J(tcf! ro LO.No.: Address: Telephone: Description 1. 1787.656 SH AMERICAN HIGH INCOME TRUST Value 22,435.08 2. PNC BANK CERTIFICATE OF DEPOSIT ACCOUNT # 31500222329 10,115.37 3. PNC BANK CHECKING ACCOUNT #943885 9,531.52 4. PERSONAL PROPERTY , 1,438.00 -',1 {.."J Ci'j Total 43,519.97 (Attach Additional Sheets if necessary) NOTE The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-15U EX AFP 112-D41 JOSEPH W NUGENT 7l4~~ERONICA LN ENO;,~~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-07-2005 NUGENT 07-07-2004 21 04-1194 CUMBERLAND 101 BARBARA Allount Rellitted PA 17025 !.'- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 c:c ~ CUT ALONG~1HIS L~! ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV :r!4"'0ix.A~p..C&1._.6~'..NoTYcE.oF.INHER.ifl'''cE.T.Ax.A.PPRA.isEM€N'~.Ai:towANCE.OR......_.........- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NUGENT BARBARA FILE NO. 21 04-1194 ACN 101 DATE 03-07-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 225.000.00 .00 .00 .00 .00 .00 .00 (8) NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent. 225.000.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) .00 209.000.00 (11) (12) (13) (14) 209.000 00 16.000.00 .00 16.000.00 I~ an assessment was issued previOUSly, lines 14, lS and/or 16. 17. 18 and 19 will re~lect ~igures that include the total o~ abh returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: .00 16.000.00 .00 .00 X 00 = X 045 = X 12 = X 15 = (19)= .00 720.00 .00 .00 720.00 ~ TAX CREDITS: n.... (+J AHOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-30-2004 CD004779 .00 360.00 PAYMENT MUST BE MADE BY 04-07-2005~. TOTAL TAX CREDIT 360.00 BALANCE OF TAX DUE 360.00 INTEREST AND PEN. .00 TOTAL DUE 360.00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' ".; , ',' ...~ )' . ., " . f 1 ~ . '~'r -) REV-1607 EX AFP (03-05) I:' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-23-2007 NUGENT 07-07-2004 21 04-1194 CUMBERLAND 101 BARBARA A MARYANN NUGENT 10200 DAVENTRY RD COCKEYSVILLE MD 21034 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ...... RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF NUGENT BARBARA A FILE NO. 21 04-1194 ACN 101 DATE 04-23-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-19-2007 PRINCIPAL TAX DUE: 720.00 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-30-2004 CD004779 .00 360.00 EREST IS CHARGED THROUGH 05-08-2007 TOTAL TAX CREDIT 360.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 360.00 INTEREST AND PEN. 48.54 TOTAL DUE 408.54 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) JD COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0801 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 016642 NUGENT MARYANN 10200 DAVENTRY ROAD COCKEYSVILLE, MD 21034 foltl ESTATE INFORMATION: SsN: lls-32-1866 FILE NUMBER: 2104-1 194 DECEDENT NAME: NUGENT BARBARA A DATE OF PAYMENT: 10/ 1 6/201 2 POSTMARK DATE: 09/07/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/07/2004 REMARKS: MARYANN NUGENT SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5627.89 TOTAL AMOUNT PAID: 5627.89 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Bureau of Imaging Document Management PO Box 280400 Harrisburg PA 17128-0400 October 12, 2012 M5 Glenda Farner-Strasbaugh Register of Wilis Cumberland Cnty Courthouse 1 Courthouse Sq Rm 102 Carlisle PA 17013 File Number: Estate of: Decedent's SSN: Date of Death: ACN: Payment Amount: Postmark Date: ~ pennsylvania DEPARTMENT OFREVENUE o `~ ~, . ~ m c.~ t-~ G~- ~ ~ -i C"-, r- p t- ~ --a r C 3 == T ~ f_ ,,. ~~~ .~ L7 ~Tr.. rJ 2104-1194 Barbara A. Nugent 118321866 07-07-2004 101 627.89 September 7, 2012 An Inheritance Tax payment on the above-referenced estate has been received and transferred to the Inheritance Tax fund. Please issue an Official Inheritance Tax Receipt for the payment amount and postmark date shown above. The date of payment should be the date on which the receipt is~prepared by your office. The receipt should be issued to: Maryann Nugent 10200 Uaventry Rd. Cockeysville MD 21034 The Department's copy of the Official Receipt should be mailed using the postage-paid Inheritance Tax bulk mail envelope (E-136)- within five (5) business days after receiving this credit letter. Please keep the receipts sorted and bound separately from the other Inheritance Tax documents when placing them in the bulk envelope. On your next Register of Wilis Monthly Report, REV-714, include the payment amount in the monthly Inheritance Tax collections reported on Line 5 and claim a credit on Line 7. Your monthly Inheritance Tax collections less the credit for this payment should equal the Total Amount Deposited on Line 12. Your efforts in issuing and mailing the Department of Revenue's copy of the tax payment receipt are greatly appreciated. Thank you for your timely attention to this matter. If you have any questions, please call me at 717-705-8915. Sincerely, ~~ i Samuel W. Shallcross, Clerk III Bank Reconciliation Division Bureau of Imaging Doc. Mangement n n I~ / ~(1 Bureau of I.D.M I PO Box 2804001 Harrisburg, PA 17128-0400 1717.705-8915 ~ www.revenue.state.pa.us