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HomeMy WebLinkAbout05-03-06 (2) 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 BRITTEN JUDY S 158 S HANOVER STREET CARLISLE, PA 17013 nn_n_ fold ESTATE INFORMATION: SSN: 174-16-3944 FILE NUMBER: 2106-0145 DECEDENT NAME: BRITTEN DALE A DATE OF PAYMENT: 05/03/2006 POSTMARK DATE: 05/02/2006 COUNTY: CUMBERLAND DATE OF DEATH: 02/05/2006 NO. CD 006654 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,643.10 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 1967 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $1,643.10 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ;..1 \ ~ OJ ~... \ tf \~ \t 'r \~ .e- ~ CJ) 'c.. o::tc )>~o JJo-< c.<. (f)mcn hiJJ. .-0 ~ OJ )>. ~ -- -..I ::t -..I---l O--;-lrn ~~% c.n ~ c.n b ~ '^ ...c... '- C> ~~ to en -J -~- ~ REV-548 EX (12-03) INHERITANCE TAX JOINT BANK ACCOUNT ADVANCE PAYMENT WORKSHEET COUNTY FILE NUMBER 21-06-0145 INHERITANCE TAX RECEIPT NUMBER DECEDENT'S NAME (LAST) (FIRST) (MIDDLE INITIAL) Britten Dale A DECEDENT DECEDENT'S SOCIAL SECURITY NUMBER DATE OF DEATH INFORMATION 174-16-3944 02105/2006 ADDRESS OF DECEDENT CITY STATE ZIP 1000 West South Street Carlisle PA 17013 NAME OFFINANCIAt INSTITUTION FINANCIAL ADDRESS CITY STATE ZIP INSTITUTION INFORMATION TELEPHONE NUMBER TYPE OF ACCOUNT o SAVINGS o CHECKING o TRUST o CERTIFICATE OF DEPOSIT II OTHER U.S. Bonds ACCOUNT INFORMATION SURVIVING JOINT OWNER INFORMATION ACCOUNT BALANCE (INCLUDE INTEREST TO DATE OF DEATH) ACCOUNT NUMBER 76,870.08 ACCOUNT TITLE AS APPEARS ON SIGNATURE CARD OR CD Dale A. Britten or Robert D. Young NAME (Last) Young ADDRESS 419 Factory Street CITY Carlisle ORIGINAL DATE ESTABLISHED 1984 - 2001 (Middle Initial) D Department of Revenue Use Only (First) Robert RELATIONSHIP TO DECEDENT Grandson PERCENT TAXABLE " STATE ZIP CODE PA 17013 TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE (First) (Middle Initial) PERCENT TAXABLE STATE ZIP CODE TELEPHONE NUMBER TAX RATE SURVIVING JOINT OWNER INFORMATION NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT SURVIVING JOINT OWNER INFORMATION NAME (Last) ADDRESS CITY RELATIONSHIP TO DECEDENT ~-. .'! i :,.J ',',", ~., Date Paid LIST DEBTS & DEDUCTIONS BELOW Amount Paid Payee D~tptlj)li) gq .-' .. , " .~ ftQ ~ - 1 ::iU ornz 1\ Ii n ;Ut,; ~i; </,,': :r[) iJ ; ":_-': : ~: -\ J'~'I' ! ,r,o :. ::.:' ~~. '~- , . J I .,. IJ '. 'f . , '. 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