HomeMy WebLinkAbout08-10-06
DEFT
REV-1162 EX(11-96i
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MAHESH I<UMAR MOGAlI
2062 NORTH 650 WEST
LA YTO~J, UT 84041
ESTATE iNFORMATION: SSN: 331-34-2983
FILE NUMBER: 2105-1046
DECEDENT NAME: VENKATADRICHAMAKURA
DA TE OF PA YMENT: 08/10/2006
POSTMARK DATE: 08/07/2006
COUNTY: CUMBERLAND
DA TE OF DU\ TH: 11/13/2005
,
NO. CD 007085
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05500708 I $2,362.89
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARI<S: MOGALI MAHESH I<UMAR
INDIRA MAHESH KUMAR
CHECI<# 851
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$2,362.89
GLENDA FAf~NER 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 05-1046
05500708
12-28-2005
REV-1543A AFP a-DOl
TYPE OF
EST. OF CHAMAKURA VENKATADRI
S.S. NO. 331-34-2983
DATE OF DEATH 11-13-2005
COUNTY CUMBERLAND
ACCOUNT
o SECURITY
[Xl SEC ACCT
o STOCK
o BONDS
INDIRA M KUMAR
2062 N 650 W
LAYTON
VT 84041
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MERRILL LYNCH 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 benefiCiary of this asse-t'.
If you feel this information is incorrect, please obtain written correction from the transfer agent, 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 P~n~Ylvania.
Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW 3E 3E 3E SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS ,,-
Account No. 872-49228
x
52,508.70
100.00
52,508.70
.045
2,362.89
TAXPAYER RESPONSE
To insure proper credit to your account;-:.1?wo
(2) copies of this notice must accompanyLi~ur
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
DOD Valuation
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
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
PART
ill
[CHECK ]
ONE
BLOCK
ONLY
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 Departm.ant 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 p,aid by you.
You must complete PART ~ and/or PART ~ below.
PART If you indicate a different tax rate, please state your
~ relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSEHS)
LINE 1. DOD Valuation I
2. Percent Taxable 2 X
3. Amount Subject to Tax 3
4. Debts and Deductions 4
5. Amount Taxable 5
6. Tax Rate 6 X
7. Tax Due 7
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the
co~plete to the best of my knowledge and belief.
):J~ ~~ ?Jit /~:2l- t~---
......'-I_.'t..lr-n T,.."IATIID
facts I have reported abo,ve are true, correct and
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