HomeMy WebLinkAbout04-10-06
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYL VANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 006538
SCHAEFFER DONOVAN ALLEN
350 ROBSON ROAD
DILLSBURG, PA 17019
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
__h_u_ fold ---------- --------
06108041 I $47.59
ESTATE INFORMATION: SSN: 191-42-9390 I
FILE NUMBER: 2105-0830 I
DECEDENT NAME: SCHAEFFER JOSEPH S I
DATE OF PAYMENT: 04/10/2006 I
POSTMARK DATE: 03/30/2006 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 08/08/2005 I
I
TOTAL AMOUNT PAID: $47.59
REMARKS:
DONA V AN SCHAEFFER
CHECK#1972
INITIALS: RSK
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG I PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 05-0830
ACN 06108041
DATE 02-22-2006
REY-1545 EX AFP (09-00)
EST. OF JOSEPH S SCHAEFFER
S.S. NO. 191-42-9390
DATE OF DEATH 08-08-2005
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[XJ CHECKING
D TRUST
D CERTIF.
DONAVAN SCHAEFFER
350 ROBSON RD
DILLSBURG PA 17019
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE~ PA 17013
H & T 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 decedentl you were a joint owner/beneficiary of
this account. If you feel this information is incorrectl please obtain written correction froll the financial institutionl 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
o~ Pennsylvania. Ques~jons may be answ9~ed by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1281747 Date 07-22-1996
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
To insure proper credit to your accountl two
(2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Willsl Agent".
x
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of deathl
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
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................~...................................
....-..........................................................
.................................................................
. . .
.. .:;:::;I!!jl~I~III!!I~~~;::...:.:.:.:.:;;;;;
[CHECK ]
ONE
BLOCK
ONLY
The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interestl 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.
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.
If you indicate a different tax rate~ please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX
LINE
RETURN - COMPUTATION
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 TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
that the facts I have reported above are true~ correct and
lief. HOME (/~7) '7Y07- ?/'c:;
WORK (7/7) ~?,?- 7~50
TELEPHONE NUMBER
Jc2~.'6
DATE
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