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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
NO. CD 005598
ALBERT BARBARA A
339 STONER ROAD EXT
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER I
____n__ fold -------.-- L____n
I
05123916 I $90.16 !
ESTATE INFORMATION: SSN: 204-03-3162 I
FILE NUMBER: 2105-0188 I I
DECEDENT NAME: BISHOP PEARL R I
DATE OF PAYMENT: 07/20/2005 I
POSTMARK DATE: 07/19/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 02/14/2005 I
I ,
!
TOTAL AMOUNT PAID: $90.16 I
REMARKS:
CHECK#186
INITIALS: JA I
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH '
REGISTER OF WILLS
REGISTER OF WILLS
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*
REV-1545 EX 'FP (D9-D~\ Gr~,
INFORMATION NOTICE
Ocr AND
(,. TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 05-0188
05123916
06-02-2005
C
OClDL
t,1 I
J
EST. OF PEARL R BISHOP
S~S. NO. 204-03-3162
DATE,.JlF DEATH 02-14-2005
cOuNty, CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[X] CERTIF.
nne IIi!
LUu,; ,,: '-'
BARBARA A ALBERT
339 STONER RD EXT
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided the Department with the inforllation listed balow which has baan usad in
calculating the potential tax dua. Thair racords indicata that at the daath of the above decedent, you were a joint owner/banaficiary of
this account. If you feal this inforllation is incorrect, plaase obtain written corraction froll tha financial institution, attach a COpy
to this forll and return it to the above addrass. This account is taxabla in accordance with tha Inheritanca Tax Laws of the Comllonwaalth
of Pennsylvania. Qusstions may bQ anzwQrad by callir.g (717) 187-a327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 21001012339 Date 06-26-1990
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
1,202.13
50.000
601. 07
.15
90.16
TAXPAYER RESPONSE
To insure propar cradit to your account, two
(2) copias of this notica must accompany your
paymant to tha Register of Wills. Maka chack
payable to: "Ragister of Wills, Agent".
x
NOTE: If tax payments are made within three
(3) lIonths of the decedent.s data of death,
you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
ill
The above information and tax due is correct.
1. You may choose to rellit paYllent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "An and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK]
ONE
BLOCK
ONLY
B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inharitance Tax return
to be filed by the decedent.s representative.
C. [] The above inforllation is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION OF
LINE 1. D7.tc Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
S. Debts and Deductions S
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
x
x
PART
[!J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on line S of Tax Computation)
Under penalties of perjury, I declare that the facts I
complete to the best of my knowledge and belief. HOME
T
are true, correct and
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