Loading...
HomeMy WebLinkAbout01-17-06 r C\ ,.:' <:.1 ~o,. [t ...... ,4,/ .., 'M i~; C) C~: ';::..;+ '<.." .~. r~_: , '" .; ,'"~ "'.. '. -,. h.>,. <: ~"'~, '<"l -. fl~ ,....~ o ~ v ,~ \:,.~ :-:> ., '" \'. 'Sc .:{~ ~0~ :.> <'~ 10 ~-~ ~ '~~'. "'~~ '~ ~ ,~ ~. \~ ~ "" \.i'. ~ .~ ~~ ~~ ~~~ \ '(, . .~ '~" ~~\\ ~ ~ ~~ "- .- - ,".1 I'n (.) (.) 4_.._ .....) , . 'r-l () j"" .,..1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAxes DEPT. 280601 HARRISQURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 . ~\; -~~,,~ 06100956 01-06-2006 REV-154! EX AFP (09-001 f" ~ 5 U EST. OF STEVE HOWRYLAK S.S. NO. 181-14-2688 DATE OF DEATH 09-13-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT fil SAVINGS o CHECKING o TRUST o CERTIF. STEPHEN F HOWRYLAK 6402 CANNON DR MECHANICSBURG PA 17050-1907 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, yoU ware a ioint owner/beneficiary of this account. If yOU fael this information is incorrect, pleasa obtain writtan correction from the financial institution, attach a copy to this form and raturn it to tha above addrass. This account is taxable in accordanca with the Inharitance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 8608084680 Date 04-05-2002 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 10,060.35 50.000 5,030.18 .045 226.36 TAXPAYER RESPONSE To insure proper cradit to your account, two (2) copies of this notice BUst accompany your payment to the Registar of Wills. Maka check payable to: "Register of Wills, Agent". Tax x NOTE: If tax payments ara made within three (3) months of tha decedent's date of death, yoU may deduct a S7. discount of tha tax due. Any inheritance tax due will become delinquant nine (9) "months aftar the date of death. PART ill A. [ CHECK ] ONE BLOCK B. ONLY c. ~ Tha above information and tax due is corract. ~ 1. You may choosa to ramit paymant to the Ragistar of Wills with two capias of this notice to obtain a discount or avoid intarast, or YOU may check box "A" and raturn this notica to the Registar of Wills and an official assessmant will be issuad by the PA Department of Revenua. If you indicate a different tax rate, please state your relationship to decedent: [J The above asset has bean or will ba raported and tax paid with the PannsYlvania Inheritance Tax return to ba filed by the dacedant's representative. [J The abova information is incorrect and/or debts and daductions wera paid by you. You Bust completa PART ~ and/or PART ~ balow. PART [!] TAX RETURN - COMPUTATION lINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED OF 1 2 3 4 5 6 7 8 x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION Under penalties of o ~"e~?*, of ? //c;zt74 T^VD^ ~D C:TQll^TIID~ I TOTAL (Enter on line 5 of Tax Computation) AMOUNT PAID I $ ry I declare that the facts I ledge and belief. 1-/2 -o{,-, n^T~ have reported above are true, ~orrect HOME (71 7 ) 7 q 1- (/3 ? 0 WORK (7/1) 7~7- ? 27 T~I ~Dunt.J~ t.Jlnnl~D and 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 HOWRYLAK STEPHEN F 6402 CANNON DRIVE MECHANICSBURG, PA 17050-1907 ___n_n fold ESTATE INFORMATION: SSN: 181-14-2688 FILE NUMBER: 2106-0048 DECEDENT NAME: HOWRYLAK STEVE DATE OF PAYMENT: 01/17/2006 POSTMARK DATE: 01/13/2006 COUNTY: CUMBERLAND DATE OF DEATH: 09/13/2005 NO. CD 006222 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06100956 I $226.36 I I , I I , I I TOTAL AMOUNT PAID: REMARKS: STEPHEN F HOWRYLAK CHECK#1588 SEAL INITIALS: RSK RECEIVED BY: REGISTER OF WILLS $226.36 GLENDA FARNER STRASBAUGH REGISTER OF WILLS