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Home My WebLink About02-02-06 COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 ~. , .- HARRISBURG, PA 17128~06Dl: '.*.' ,. '. \ INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 05-0956 06101049 01-06-2006 REY-15~S EX AFP (09-00' ., ;.~ ',i r' - '2. c\', \ '..', (.. \ \1, I c EST. OF SCOTT IAN S.S. NO. 225-98-1279 DATE OF DEATH 10-16-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [X] CHECKING D TRUST D CERTIF. DAVID A DECRENY 205 WOOD ST CAMP HILL PA 17011-2640 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK 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 were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance 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. 2331036632 Date 02-14-2000 Established x 1,021.35 16.667 170.23 .15 25.53 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x Tax NOTE: If tax payments are made within three (3) months of the decedent.s date of death, you may deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART [!] The above information and tax due is correct. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" 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 Inheritance Tax return to be filed by the decedent.s representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. TAX ON JOINT/TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: 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 OF 1 2 3 4 5 6 7 8 x x PART @J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. TAXPA~NA~~ I $ have reported above are true, correct and ( 7( 7 ) 7 '3/- ('r;J.9 WORK ( ) TELEPHONE NUMBER HOME / -22-0(, DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128.0601 REV.1162 EX(11.96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 006272 DECRENY DAVID A SR 205 WOOD STREET CAMP HILL, PA 17011 ACN ASSESSMENT CONTROL NUMBER AMOUNT ___nn_ fold 06101049 $25.53 ESTATE INFORMATION: SSN: 225-98-1279 FILE NUMBER: 2105-0956 DECEDENT NAME: IAN SCOTT DATE OF PAYMENT: 02/02/2006 POSTMARK DATE: 01/23/2006 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 6/2005 TOTAL AMOUNT PAID: $25.53 REMARKS: DECRENY DAVID A CHECK# 6233 SEAL INITIALS: MG RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS - - - - - - - - - - - - - - - - - - - - - - - - - - - == - - - ~ \ \ T .... '" a>> ~ a. 'OJ 0 ()~o ~ ? III ~ :! 3 ~.... (') ~~~ Co) 8 -oS/2 )>. ~ g ..... t \ \ ~g~!J :D~rn~g :D. :D__ U51i=ic~ UJI:)~O:D ~g(')..,~ G')-rnZrn "0 ;2~ ~ ><==0 ..... 00.., - :::C::D Ii ->m b g!r-< en o;rn I:) %><% - c: mrn "12 .!\ 'v ""', 'j (, '.. .. 1'1 . :; 2. .- i .. .~" -oJ;;, }~ ::G "t~ ,~~ ~~. ~j) l'\J j':'^' ""....,,' 7:1 tl \'~\\\\\ \'" '\ '\ . 1 ~d ~ ~1 fit' ,1 l J ' ~. if { " I ! " ~ l l; ;! J I 1 t j 1 t ~