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Home My WebLink About03-02-05 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LEZZER DOLORES B 410 GREENSPRING ROAD NEWVILLE, PA 17241 -------- fold ESTATE INFORMATION: SSN: 175-20-1847 FILE NUMBER: 2105-0197 DECEDENT NAME: LEZZER MARY R DATE OF PAYMENT: 03/02/2005 POSTMARK DATE: 03/02/2005 COUNTY: CUMBERLAND DATE OF DEATH: 08/07/2004 NO. CD 005011 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04146151 I $460.68 04146150 I $65.78 I I I I I I I TOTAL AMOUNT PAID: $526.46 REMARKS: D B LEZZER CHECK# 7405 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~~. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 H*' :, '..; FILE NO. ACN DATE 21 - 05-1Q7 04146151 12-14-2004 RErc!fUEX 'iff tD9~iJh d~FORMATlNO~ NOTICE \CTAXPAYER RESPONSE f)"f\C L\l\.!u -2 M,\\\:43 TYPE OF ACCOUNT EST. OF MARY R LEZZER IXJ SAVINGS S.S. NO. 175-20-1847 0 CHECKING DATE OF DEATH 88 89 i!864 06>-07-0'10 TRUST COUNTY CUMBERLAND 0 CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 DOLORES B LEZZER 410 GREENSPRING RD NEWVILLE PA 17241 FRANKLIN COUNTY TEACHERS CU has provided the DepartBent with the inforntion listed below which has been used in calculating the potential taK due. Their records indicate that at the death of the above dBCedent, you were a joint owner/beneficiary of this account. If you feel this inforBation is incorrect, please obtain written correction frOB the financial institution, attach a copy to this forB and return it to the above address. This account is taKable in accordance with the Inheritance TaK Laws of the COBeonwealth of PennsYlvania. Questions Bay be answared by callIng (717) 787-83Z1. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31512 Date 07-29-1993 Established Account Balance Percent Taxable A.ount Subject to Tax Rata Potential Tax Due x 61,422.87 16.667 10,237.35 .045 460.68 TAXPAYER RESPONSE To in sura proper credit to your account, two (Z) copies of this notice BUSt aCCOBpany your paYBent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If taK paYBents are Bade within thrae (3) Bonths of the decedent's date of death, you Bay deduct a 5;C discount of the taK due. Any inheritance taK due will becoee delinquent nine (9) Bonths after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. ~The above inforBation and taK due is correct. 1. You Bay choose to reBit paYBent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you Bay check bOK "A" and return this notice to the Registar of Wills and an official assesSBent will be issued by the PA Departeent of Revenue. c=l The above asset has been or will be reported and taK paid with the Pennsylvania Inheritance TaK return to be filed by the decedent's representative. c=l The above inforBation is incorrect and/or debts and deductions were paid by YOU. You BUSt coeplete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to dacedent: PART [!] TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. ~unt Subject to Tax 4 S. Debts and Deductions S 6. Mount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury, I declare that the facts I cOBPlete to the best of .y knowledge and belief. TAYPAv1;~~ ,;!~/f I $ have reported above are true, correct and HOME (7/7) 77~ -,57/L- WORK (' ) TELEPHONE NUMBER ot:TitJS ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-o601 *, \ ,~. INFORMATION NOTICE ,C;,'fIAXIfA,\(r~~~ES PONS E FILE ACN DATE NO. 21 -- 0 5-lql 04146150 12-14-2004 REV-1545 EX iFP In,OS ....u~jti 'J TYPE OF ACCOUNT 2 :ft~\.\ :O~.,)MARY R LEZZER IXJ SAVINGS S.S. NO. 175-20-1847 0 CHECKING CLEnK"'~TE,.,_OF DEATH ..8 6l)-1IID1t o81(J1-/o~D TRUST CQ1JNT\Y CUMBERLAND 0 CERTIF. .- r\\ REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 EDWARD C LEZZER 410 GREENSPRING RD NEWVILLE PA 17241 FRANKLIN COUNTY TEACHERS CU has provided the DepartBent with the inforBation listed below which has been used in calculating the potential taK due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this inforBation is incorrect, please obtain written correction frOB the financial institution, attach e copy to this forB and return it to the above address. This account is taKable in accordance with the Inheritance TaK Laws of the CoeBonwealth at Pannsylvania. Questions BaY be answered by calling (717) 781-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 31512 Date 07-29-1993 Established x 61,422.87 16.667 10,237.35 .045 460.68 TAXPAYER RESPONSE To insure proper credit to your account, two (Z) copies of this notice BUst aCCOBpeny your pa~ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Mount Subject to Tax Tax Rate Potential Tax Due x NOTE: If taK paYBents are Bade within three (3) Bonths of the decedent's date of death, you Bay deduct a 5;C discount of the taK due. Any inheritance taK due will bscOBe delinquent nine (9) Bonths after the date of death. PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. c=l The above inforeation and taK due is correct. 1. You Bay choose to ruit paYBent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay check bOK "A" and return this notice to the Registar of Wills and an official assesSBent will be issued by the PA Departeent of Revenue. c=l The above asset has been or will be reported and taK paid with tha Pennsylvania Inheritance TaK return to be filed by the decedent's rapresentative. ~he above inforBation is incorract and/or debts and daductions were paid by you. You BUSt coeplete PART ~ and/or PART ~ below. OF 1 2 3 X 4 S 6 7 8 X ON;t.OINT/TRUST ACCOUNTS 7 ?--9 / /'111 '6/,il-VY' 7 /h. h6 7 /~, 2--37, 36 ;; '7 '7S, E;t) /461.~.s- " tJ4-5 bS. 7 t' DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: ~,o /J PART [!] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. A.ount Subject to Tax S. Debts and Deductions 6. Mount Taxable 7. Tax Rata 8. Tax Due TAX PART [!] DATE PAID 3/ PAYEE DESCRIPTION I AMOUNT PAID TOTAL . ;tJS""" ~ Z-S'.. t) ~ g? 7.: .:1" r~ facts I have reported above are true, correct and HDHE (~71 nl --tfZI h- WO~ ( '); ~ - ~~/11~ T LEPHO E NUM ER $ Under penalties of perjury, I declare that the ~'fl.~' 7"~ ..11... P Vi=P c: n::N T E P'J.-- ~1-l17Ld lJdh 1- fJ~.~eh J/?.5 Uefl ~ f ?J /;'6 / ~ Jf f1:u;J; Cr-rcu~ I LL- ~~t~~ 0/;8/(/1 trn~J-r1 bu-hrn k~ t (p~ h(b{f ~~Y/UA/L~ q/&-)o+ ;J~h;G1oJ~Ilt1-L (J b f~ry-- Alrh cL 5/;g/II1 ~fylbvuhhJ - f.A4~ ~/ trEK- 'i L 2/&5/01 JJ~V't /u WIh1A t/~ lntJrI ~~h PY1 Prv bUL--~ i UJ~L~/r ~~ItU- / (l-tJ fY7 J1/1 ~ A-L q } 3/0 f 1:t/Lej:: ~ ~ 1--0 IY/l ;;J, ~ 3//0/01- ~A~ ~ ~J, I~ Q/,o/iJf (!rnJnbuhrYl ktL(~ bo-z-;s 9tJ,ZJ~ 7.,:), 00 ~t7,. 00 7-5...otJ S-IJ.OO 3:;.. Ct) ?~oo .;( IJ - t/o I :;- 350. 0 tJ