HomeMy WebLinkAbout09-07-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX" 1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ROHRBACH BOBBIE JEAN A/K/A
7407 WERTZVlllE ROAD
CARLISLE, PA 17013
n______ fold
ESTATE INFORMATION: SSN: 186-34-2591
FILE NUMBER: 2105-0531
DECEDENT NAME: ROHRBACH MARY C
DATE OF PAYMENT: 09/07/2005
POSTMARK DATE: 09/06/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 05/31/2005
NO. CD 005773
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05133195 I $51.19
I
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 2070
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$51.19
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PEHNSVlYANlA
DEPARTMENT OF REVENUE
BUREAU DF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
*'
INFORMATION NOTICE
-,.,Atim-r"' f\Cr,,"'r J'(
TAXP~Elln~~~if7(
FILE NO. 21 05-0531
ACN 05133195
DATE 07-19-2005
I'EV-lSUEkU-'Clt-,O,
BOBBIE J CRONE
7407 WERTZVlllE RD
CARLISLE PA 17013
TYPE OF ACCOUNT
Eili:~.S~ -M1R.f~tl~o~JBACH 0 SAVINGS
S.S. NO. 186-34-2591 iii CHECKING
DATE Q!".lI!llM'li 0~5-31-2005 0 TRUST
CO~Y . ~UMilERlAND 0 CERTIF.
/", ..,.. ~.,
REilIT PAVHENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
BANK OF LANDISBURG has provided the Deparbent with the infar.stlon listed below which has bHn used In
calculating the potential ta)( due. Their records indicate that at thll death of thg above decedBOt, you were a joint owner/benaficlary of
this aecount. If YOU feel this infor~tion is Incorr8Ct, please obtain wrlttan correction fro. ~ financIal institution~ attach a copy
to this fa,.. and return it to the above address. This account is taxable in ilWcord8nca with the Inheritance Tax laws of the COII*lownlth
of Pennsylvania. Questions .a~ be answered b~ csll!ng C7l7> 787-8327.
COMPLETE PART 1 BELOW
Account No. 3702804
. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Dat. 02-05-2002
Established
Account Balllllce
Percent Taxable
A.ount Subiect to Tax
Tax Ret.
Potential Tax Due
x
2,274.90
50.000
1,137.45
.045
51.19
To ihsure proper credit to your account, two
(2) caplB$ of this notice ItUst aCC:ClIIpany yaut'
pay-.mt to the RBllIister of Mills. Ml!lke check
payable to: ""Registet' of Wills, Agent..,
x
NOTE: If ta)( paywrsnts ara .<lde w.ithin thrH
(3) .-onths of the dBcedent.s date of death,
you IIBY dliIIduct a S;C discount of the tax dLle.
Any inheritance tax due will beCOIle d8linquant
nlne (9) .onths after the data of death.
PART TAXPAYER RESPONSE
[TI"_.__4~;_
-,~..,""-",~""'...,",..'~ .,.. ."......~.~,.. ~.. "'. . ... .. "'-.. .!1!l",._ ""_. ~_'. ,. '. '_~ ~._.~,..,...~~-"r.-.~~._"'~,r.. .~...... .....-~"'. ... ~_~."'.,... ~,.,...~. . ... _._ "'.., .~,~..... .'h .._ _ ~.."'~.;;;~,~. ..'.'..~....~_... """ . ~,..,..,.._ ..~.~. _,~._.
... . ...... ...... ..... .... ~ .__ . _.. ..~. "... ~.' ...... .._' . no .... '_'.. ._ _ ...~. .. ~..,....~_~. '.~' .,_.. . ..,._.. ._. ~... ._.~ ..... ._.~ _.._ ~~....... ~ "__" _.~. "'" ....~. .~.. _....
A. ~hiI above lnforll8tion and tax deJa is correct.
I. You If8Y choose to r_lt pay.sot to the Reglstet' of Mills with two copies of this notice to obtaIn
a dlscolM1t or avoid inter8st~ or you MY check box "A" and return this notice to thlI Register of
Wills and an official assesSIIent will be issued by 'the PA PapBY'ment of Revlll1U8.
[CHECK ]
ONE
BLOCK
ONLY
B. 0 The above ass.t has been or will be report8d and tax paid with the Penn~lvan1a Inheritance Tax return
to be flJed by the decedent"s reprIJsentative.
C. 0 The above infor.aUon is incorrect and/or debts and deductions ,",r8 paid by you.
You .ust co.plate PART 0 and/or PART ~ below.
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
I'f you indicat. a diff.rent tax rate, please st.te your
re1ationsh1p to decedent:
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT~TRUST ACCOUNTS
LINE 1. Dat. Established 1
2. Account Balance 2
::S. Percent Taxabl. 3 X
11\. hount Subject to Tax 4
S" Debts and Deductions .5
6" Allount Taxable 6
7. Tax R.t. 7 X
8. Tax Due 8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Lin. 5 of Tax C~ut.tlon)
I
.
pen.ltias of perjury~ I declare that the facts
of .Y knowledge and belief.
"
I have reported _ove are trutJ, correct and
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