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Home My WebLink About07-11-05 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX01-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HUMMEL THERESA M 900 RIDGE ROAD CARLISLE. PA 17013 _un___ told ESTATE INFORMATION: SSN: 201-03-8373 FILE NUMBER: 2105-0618 DECEDENT NAME: FOX MARTHA M DATE OF PAYMENT: 07/11/2005 POSTMARK DATE: 06/30/2005 COUNTY: CUMBERLAND DATE OF DEATH: 01/04/2005 NO. CD 005546 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05116769 I $530.36 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: THERESA M HUMMEL CHECK# 3623 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS $530.36 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES_ DEPT. Z8D601 HARRISBURG.. PA 171za-06QI *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 05116769 DATE 05-27-2005 m-15of$'[X.FPlDt-fl)) \1" i I .....L:_ I I i-II 2~ 37 TYPE OF ACCOUNT EST. OF MARTHA M FOX 0 SAVINGS S.S. NO. 201-03-8373 !Xl CHECKING DATE OF DEATH 01-04-2005 0 TRUST COUNTY CUMBERLAND 0 CERTIF. REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 THERESA 900 RIDGE CARLISLE M HUMMEL RD PA 17013 "EHlERS 1ST FEDERAL CU has provided ths DeparbIBnt with the info~iIItlon listed below which has bun used in calculating the potentIal tax due. Their recQrds indicate that at the death of the above decedent.. YOU were ill joint ~r/beneflciar~ of this account. If YOU feel this lnfor~tlon is incorrect.. please obtain written correction fro. the financial institution.. att8ch a cOPY to this fo~ and return It to the above address. This llIccount is oxabl. in accordance wIth the Inheritance Till)( Ll!INs of the COIIIIOnwealth of PlII'Insylvanill. Questions ay be answered by calling (717) 781-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 155453-11 Il1ot. 11-28-1995 Est....U...ed Account Balance PerClM1t Taxable Allount Subj""t to Tax Rat. PotantJal Tax Due lC 23,571.56 50.000 11,785.78 .045 530.36 To Insure proper credit to your account.. two Cll copies of this notice Mist accbllpany your p8)1.ent to the Register of Wills. Make chllck payable to: ""Rqlstlllr of Wills.. Agllnt"'". lC NOTE: If OK pa~ts are _de Nithin three (3) IIDnths of the decadent's date of dnth.. YOU .ay deduct iii ~ discount of thg tax. due. Any inh8ri tance talC due will baeo.e dIIUnquent nine (9) .onths after t:he dIlta of death. Tax PART TAXPAYER RESPONSE m_.~.,__ ''''.'''';;;-''''''''' ",.-",,,,;;!;;;~._~.~. ~... ..~ .,_. . . ..~~~~~~...."'" . ....m.. .-.'~- ..'~....... , _ .1!1...- ..,.... ....,.~;.,,, "''''..._.........,~~,. .~.,....-"';!;- "'.... .._...~..._,~"';;; _"'...... ".... G.....' ...~~. ..."'. ''''_'' ..... ".'...". .. .-. ..".~ ..... .". ......~.. ....-...... ."'- .... ........." ~ ...--.. - ....... ...~.. -- -...- ~""'. . ....~ "''''~;<; -~ ...... . ....- .~_. ....~ .... ~; . .......~ -- ...- -''''-'' ~..... ~.- . "'. . '" ~ ...--. ... ". .~ [CHECK ] ONE BLOCK ONLY A. IVf The above InfoMRiltion and tax dull is correct. ~ 1. You.ay choou to r_it Pl!!lYll8l1t to the Registlllr of \Ulls with two copias of this notice to obtain 8 dlscolmt or avoid Interest.. or YOU .ay cheek box "A" and return this notice to the RegIster of Wills and an official assess.ant ,!till be issued by the PA Deparblilnt of Revenue. B. 0 The above assat has been Dr will be repat"ted and tax. paid with the Pennsylvania Inheritance Tax return to be filed by the dllcecklnt"s npresentative. C. [] The above infor.atlon is incorrect and/or debts and deductions Wlilra paid by you. You .ust co.pleu PART 0 and/or PART ~ billow. PART I!I DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicat. a d1ff....snt tax ratel pIns. state your nJlationshlp to decedent: PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LXNE 1. o.t. Estab1~Shed 1 2. Account Balanc. 2 3. Percent Taxable 3 X 4" Allount Subject to Tax 4 5. Debt. and o.ductions 5 6. gaunt Taxabl. 6 7. Tax Rat. 7 X 8. Tax Iluto 8 PAYEE DESCRIPTION AMOUNT PAID I . I TOTAL (Ent.,. on Line S of TlIX COIIput.tlon) facts I ....v. reported Move ..... true I correct and HOME ("7/7) 298 -J'l/<j WORK qq ) ?-,,~- -"1'170 DATE ~~ .t ~. ... - - ~b \\\ - - l'ijO;'. ~- '~ c ,- "" , - \ .. N q; ~ % 0 " .... J:,&~ \l\"n. "c:>- (i)~~ ~O::'-- >-Si'i, ~'" t It. ~ ;;. U1Sl ~ ffi~~ ~ Gia~ ~ ~::la r- ~e)( < ~4 Q,; ii'i!$~ ~~~i9i ~::l\::N>> O:~a:":i '8a:~fti4 4'aZC:C 0.-- \ ~ == ~ ~ ~ - -: - 1 - -= -: - ~ - '1 - ~ =' -= : - 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 HUMMEL THERESA M 900 RIDGE ROAD CARLISLE, PA 17013 nu_.__ fold ESTATE INFORMATION; SSN: 201-03-8373 FILE NUMBER: 2105-0618 DECEDENT NAME: FOX MARTHA M DATE OF PAYMENT: 07/11/2005 POSTMARK DATE: 06/30/2005 COUNTY: CUMBERLAND DATE OF DEATH: 01/04/2005 NO. CD 005544 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05116751 I $6.83 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: THERESA M HUMMEL CHECK# 3622 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WillS $6.83 GLENDA FARNER STRASBAUGH REGISTER OF WillS COMMONWEALTH OF PENNSVLVANIA DEPARTIENT DF REVEtrIJE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-D6Dl '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 05116751 DATE 05-27-2005 REV-l!iUEX AfP lI9-IOJ EST. OF MARTHA M FOX S.S. NO. 201-03-8373 DATE OF DEATH 01-04-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT !Xl SAVINllS o CHECKING o TRUST o CERTIF. tI" " -. 3"} ......,,- PA 17013 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 THERESA 900 RIDGE CARLISLE M HUMMEL RD HEI1BERS 1ST FED CU has providtld the DeparbBnt with thB Inforllation listed balow which has bBBn used in calculating the patllntial tax due. ThIIlr records Indicate that at the daath of thB above dscedent, YOU were a joint olH1lllr/beneficiary of this account. If YOU "'el this Infor.atian is Incorrect, pleaH obtaIn writtsn correction fro. the financial institution, attach a copy to this fonl and return it to the above address. This account is tllxablB In accordanca with the Inherlt.,ce Tax Laws of thll Co..ol'1W'lllBlth of Pennsylvania. Iiluestians bY be ansW'lllred by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 155453-05 Oat. 11-28-1995 Established Account Balance Percent Taxable AlIount Subj""t to Tax R.te Potential Tax Due x To Insure proper cradit to your ItCCOlrlt, tNo (Z) capias of this notic. .ust accu.pany your pay..,t to tha Ragistllr of Wills. Milk. check payabls to: "RegIstllr of Wills, Agent-. T.x 303.73 50.000 151. 87 .045 6.83 TAXPAYER RESPONSE ~~"."Jm.ln_.~.lII1l.I~I.~lt.::;:;:;':m,:,,:~"':~:;.:~j::~"':..;:1r~"::";~;,,",,,,,.II_II~ x NOTE: If tax pay_ants are l18de wi thin thrBS (3) .onths of the dacBdent.s date of death, YOU .ay deduct a 5~ dIscount of the tax due. Any inhsri tance tax due will becn.. dellnqusnt nins (9) .anths aftllr the data of death. A. r\7I The above infor.atian and ux due is correct. ~ I. You Bay ChOOH to r..it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or YOU .ay check box -A- and return this notice to the Register of Wills end an official assassaent will be issued by the PA nepartBent of Revenue. [CHECK ] ONE BLOCK ONLY B. D Thti above asset has baen or will ba reported Wld tax paid with the Pemsylvania Inhar!t.,ce Tax return to be filed by the decedent's representatlva. C. [] The above infor.ation is incorrect end/or debts and deductions NBre paid by YOU. VOU .ust cDllplete PART 0 and/or PART @J beloN. PART [!l DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please stat. your relationship to d8C8dent: PART [!l TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE I. Dot. E.tllbllshed 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Mount Subject to Tax 4 5. Debts and Deductions 5 6. A~unt Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Co.putatlon) I . of perjury, I declare th.t the facts I f ." knowlllC!gll _ "'11.f. have reported above ar. true, correct HOME (7/7) :"'SJ> -J U.J> WORK (-'-/7.) ':L. '+ S -7"17t1 TEL 0 E - (" /::L7/0f DATE \ \1 \ '; . ; - - - - c-t> en ~U1. ~ z~'Z i \~% ! U.aa ~ o-~ "" ~4 0. i~,;~~ ~'5~i'i 4at:,l~ ~W~ .... cet.!'i.i ",,;azc-:s: 0.-- i If> ~ ~ ~ <l' ~ ';; l ';}, E ~ :> g :J:-a~ i~~ ....~Iti ~.~1i ~ r-v..__ ~~~ Ii!. . ~. . \ \ ::::. = ~ - -: : ~ - -= ~ == -= == ~ ~ - S '1 :; ~ ~ -