HomeMy WebLinkAbout08-02-06
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T 4.XES
Hi:..RRIS8URC~ =
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SNELL SHIRLEY E
106 HUMIVlEL AVENUE
LEMOYNE, PA 17043
,
I ESTA TE INFORMATION: SSN: 296-07-9759
FILE NUMBER: 2106-0678
DECEDENT NAME: I<ONICH HAZEL l
DATE OF PAYMENT: 08/02/2006
-
POSTMARK D,LHE: 08/01/2006
-
COUNTY: CUMBERLAND
DATE OF DEATH: 05/17/2006
NO. CD 007045
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
06137390 I $50.00
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TOTAL AMOUNT PAID:
REMARI(S: SHIRLEY SNELL
CHECI(# 7757
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$50.00
GLENDA FARNER STRASBAUGH
REGISTER OF WilLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 ~o(p-N.oli
06137390
07-26-2006
REV-1543 EX AFP {09-00>
EST. OF HAZEL L KONICH
S.S. NO. 296-07-9759
DATE OF DEATH 05-17-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[i] CHECKING
o TRUST
o CERTIF .
SHIRLEY E SNELL
106 HUMMEL AVE
LEMOYNE PA 17043
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC 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 incorrectl 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 bv calling (71]) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140035451 Date 04-01-1972 To insure proper credit to your account, two
Established (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
2,143.96
50.000
1,071.98
.15
160.80
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) months of: the decedent.s date of death,
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
x
PART
[!]
A. [] 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 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.
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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 i' incorrect nd/or debts and deductions were paid by you.
~ You must complete PART 2 a PART ~ below.
OF
1
2
3
4
5
6
7
8
TS
If,.you indicate a different tax rate, please state your
reiBlionship to decedent:
P:ART
@
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
c'~, ,~
PART
@]
DATE
..j6. u ~
DEBTS AND DEDUCTIONS CLAIMED
PAID
DESCRIPTION
e.
AMOUNT PAID
_ 00
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.
P?'~/ p /
~+A L A-AP/P?/
TA'l(P VFR SI ATURE
$
have reported above are true, correct and
(71"7 ) 70 :1-- ?')> d
WORK ( )
TELEPHONE NUMBER
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