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Home My WebLink About03-15-05 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 LENGEMAN WILLIAM I JR 700 BEACON HILL ROAD NEW CUMBERLAND, PA 17070 -------- fold ESTATE INFORMATION: SSN: 195-07-6263 FILE NUMBER: 2105-0246 DECEDENT NAME: LENGEMAN FRANCES P DATE OF PAYMENT: 03/15/2005 POSTMARK DATE: 03/14/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/01/2004 NO. CD 005064 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05107957 I $169.31 I I I I I I I I TOTAL AMOUNT PAID: $169.31 REMARKS: WILLIAM I LENGEMAN JR CHECK#314 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLYANIA DEPARTMENT OF REVENUE BUREAU OF INDIYIJ]I,IA~\T"l(ES DEPT. Z80601 . <.... HARRISBURG, PA IU28~1I601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21- ~S -~"';:)..\..\ ~ ACN 05107957 DATE 03-02-2005 REV-1545 EX AfP lU,-DDI 'i EST. OF FRANCES P LENGEMAN S.S. NO. 195-07-6263 DATE OF DEATH 11-01-2004 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST IX] CERTIF . WILLIAM I LENGEMAN JR 700 BEACON HILL RD NEW CUMBERLAND PA 17070 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYPOINT BANK has provid..d th.. D..part...nt with th.. infor.ation list..d b..low which has b....n used in calculating th.. pot..ntial tax du... Their r..cords indicat.. that at th.. d..ath of th.. abov.. d..c..d..nt, you w..r.. a joint owner/b..n..ficiary of this account. If you f....l this inforBation is incorr..ct, pl..as.. obtain writt..n corr..ction froB th.. financial institution, attach a copy to this forB and return it to the abov.. addr..ss. This account is taxable in accordance with th.. Inheritance Tax Laws of th.. COBBonwealth of Pennsylvania. Qu..stions .ay be answ..red by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . S~E REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 756276830 Date 04-15-1995 Established Account Balance Percent Taxable AIIount Subject to Tax Rate Potential Tax Due x 2,257.52 50.000 1,128.76 .15 169.31 TAXPAYER RESPONSE To insure proper credit to your account, two (Z) copi..s of this notice BUst accoBpany your peYBant to the Register of Wills. Mak.. check . payable to: "Register of Wills, Agent". x NOTE: If tax paYlllUlts ara Bede within three (3) Bonths of the d..cedent.s date of death, you ..y deduct a 5X discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) Bonths after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. ~ The abov.. inforBation and tax due is correct. 1. You Bay choose to rnit paYHnt to tha Regist..r of Wills with two copias of this no tic.. to obtain a discount Dr avoid interest, or you Bay check box "A" and return this notic.. to the Regist..r of Wills and an official assesS8..nt will be issued by the PA Depart.ant of R..v..nue. c=l The above asset has be..n or will be reported and tax paid with the Pennsylvania Inheritence Tax return to b.. fil..d by the d..cedent.s representative. r=J The above inforBation is incorrect and/or debts and deductions were paid by you. You Bust coaplete PART ~ and/or PART ~ below. &.ZNC .:L _ ~ J:_"-~._ 1 PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS 2. Account Balance 3. Percent Taxable 4. A.ount Subject to Tax 5. Debts and Deductions 6. A~unt Taxable 7. Tax Rate 8. Tax Due 2 3 X 4 5 6 7 X 8 PART [!] DATE PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax COMPutation) I $ Under penalties of perjury, I declare that the facts I COMPlete to the best of ~ knowledge and belief. W~'-'-- ~~- TAXPAYER SIGNATURE ~ have reported above are true, correct and HOME (7/7) 774 (03'3 WORK ( ) TELEPHONE NUMBER n^T~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-' '62 EX!' '-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LENGEMAN WILLIAM I JR 700 BEACON HILL ROAD NEW CUMBERLAND, PA 17070 ___nn_ fold ESTATE INFORMATION: SSN: 195-07-6263 FILE NUMBER: 2105-0246 DECEDENT NAME: LENGEMAN FRANCES P DATE OF PAYMENT: 03/15/2005 POSTMARK DATE: 03/14/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/01/2004 NO. CD 005063 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05107958 I $ 1 71 .44 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: WILLIAM I LENGEMAN JR CHECK# 313 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS $ 1 71 .44 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COIOOlHWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAl-TAXES DEPT. Z80601 ... HARRISBURG, PA 171Z8~a6Ql' -w INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 -<:)5 - ~").\..\C.o ACN 05107958 DATE 03-02-2005 REV-lSq! EX AFP (09-00) ~~~ II I TYPE OF ACCOUNT EST. OF FRANCES P LENGEMAN 0 SAVINGS 5.5. NO. 195-07-6263 0 CHECKING DATE OF DEATH 11-01-2004 0 TRUST COUNTY CUMBERLAND [X] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WILLIAM I LENGEMAN JR 700 BEACON HILL RD NEW CUMBERLAND PA 17070 WAYPOINT BANK has provided the Depart_nt with the infora.tion 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 joint owner/beneficiary of this account. If you feel this inforaation is incorrect, please obtain written correction froa the financial institution, attach a COpy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth of Pennsylvania. Questions aay be answered by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 758276829 Date 06-19-1994 Established Account Balance Percent Taxable AMOUnt Subject to Tax Tax Rate Potential Tax Due x 2,285.79 50.000 1,142.90 .15 171. 44 TAXPAYER RESPONSE To insure proper credit to your account, two (Z) copies of this notice aust accoapany your payaent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payaents are aade within thrae (3) aonths of the decedent's date of death, yoU aay deduct a 5" discount of the tax due.. Any inheritance tax due will becoae delinquent nine (9) aonths after the date of death. PART [!J A. [ CHECK ] ONE BLOCK B. ONLY c. o The above inforaation and tax due is correct. 1. You aay choose to reait payaent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU aay check box "A" and return this notice to the Register of Wills and an official assessaent will be issued by the PA Departaent of Revenue. o The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. o The above inforaation is incorrect and/or debts and deductions were paid by you. You aust coaplete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Dat. Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the complete to the best of my knowledge and belief. IJ J.J..1; ~ r:L.vY4~ TAXPAYER S~NATURE - ~- ..J facts I have reported above are true, correct and HOME (7';) 77 't '/0 '33 WORK ( ) TElEPHnNI= NIIMllCD tfr'''---'' .. ..' \ [ l)"~ <:..~1>- '- / iC"1 ~.: c:-::: n l[l: ~ ~ '0 I! \-:-J, '. 0, \'. ~ ~('V ' ".. ,~' ',..:1 I f; .',-'.' i . ,,< ').' ' I ~ i ~~ ~ - ~~ .~ . ; ~ ~ I~~ -0 ~ ~~ '! 1 r .' ..\ i d t- j ! 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