HomeMy WebLinkAbout12-21-06
COMMONWEALTH OF PENNSYLVANIA
IEPARTMENT OF REVENUE
BUREAU OF INDIV)~AL TA~S
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
I.N..FORM. ATION NOTICE
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FILE NO. 21 DI..o II ~,
ACN 06159525
DATE 12-05-2006
IEV-lli45 EX AF, (89-'11
BRIAN B LOOKER
4 MOVA LN
SANTA FE ME 87508
2006 DEC6t. 4/f &\BiJ B LOOKER
S.S. NO. 172-01-5053
OR CUDitaJ~F DEATH 10-15-2006
cW'lf~:~r-~RT CUMBERLAND
'i ": . ! 'I, PA. REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLEI PA 17013
TVPE OF
ACCOUNT
D SAVINGS
Iil CHECKING
D TRUST
D CERTIF.
PIle BAlIK has provided the Depart.ent with the info~ation listed below which has been used in
calculating the potential tax dull. Their rllcords indicatll that at thll death of thll abovlI decedent, you were a joint owner/beneficiary of
this account. If you fllel this infor~tion is incorrllct, pleaslI obtain written correction fro. thll financial institution, attach a copy
to this fo~ and return it to thll above address. This IIccount is tIIxablll in IIccordllnce with thll Inhllritancll TIlX L_s of the Co-.onwllalth
of Pennsylvllnill. Clullstions ~y ~ IIDsMltred by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5080033162 DIIt. 02-09-2006
EstabUshed
Account Balenc.
P...cent Taxabl.
Mount Subject to Tax
Tax R.te
Potential Tax Du.
x
131682.19
100.00
131682.19
.045
615.70
TAXPAYER RESPONSE
To insurll propllr cradi t to your IICcount, two
(2) copills of this notice ~st acc~any your
paYIIllnt to the Register of MUls. M8k1l check
pa:l/llblll to: "RlIgister of MUls, ag.,t".
x
NOTE: If tax paYll8l'lts are II8de within thrll8
(3) IIOrIthS of thll deClldllnt's dIIte of death,
you _y deduct a 5iC discount of the tax due.
Any inher! tance tax due will ~ delinquent
nine (9) .onths lifter the dllte of deIIth.
PART
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iliF___"ib!n'-_~_+os._.__ ~~.s..,,=;;j.~r-'--c_;~"""L"~C--"~_ ~ .==1:0. . _"b-~ ,~:?- ____~.,._n;E:_mc~-:!U,;-~:_~-__~~_=__.".______~.r__=_=__________Tr_~_________ -.C__.___ _.".:_=__~_ ___ __ =____ .:'-.::;;;;;;
___..~~..~__..._..;;:1..*..~~....._~~'"'.:.... ~'i: ~~_ ~_................_....q..d:J:U~.......... _____..;..0.::..._.._ ..._--.......___.._--'__~.;.....__~___..~____~______...........----~
[CHECK ]
ONE
BLOCK
ONLV
A. 0 The above infor.lltion and tax dUll is.correct.
I. You .ay choose to rHit paY.lInt to the RlIgister of Wills with two copies of this notice to obtain
II discount or IIvoid interest, or you .ay check box "A" and return this notice to the Register of
Mills and an official assllsseant will be issued by thll PA Oepart.ent of Revenue.
B. 0 The above asset has belln or will be reported end tax paid with the Pennsylvllnill Inhllritence Tax rllturn
to be filed by the declldent's rllpreslIntativlI.
C. ~The above infor..tion is incorrllct end/or debts and deductions werll paid by you.
You .ust co~lete PART [!] and/or PART [!] below.
If you indic.t. . diffe..ent t.x ...tel plaas. state you..
...lationship to deced.nt:
PART
~
TAX RETURN - COMPUTATION OF TAX ON JOINT,TRUST ACCOUNTS
LINE 1. DIIte Established I O~ - tyq - :uJO t,
~: :::::'"'7. ~~ ':3Jil
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7. Tex Rat. 7..., ~ /lllfiE
8. Tax Du. 8 ~. ::J.-:t-
PART
~
DATE PAID
DEBTS AND DEDUCT10NS CLAIMED
PAVEE
DESCRIPTION
AMOUNT PAID
TOTAL (Ent... on Line 5 of Tax Co~utation)
Unde.. penalties of p...ju"YI I decl.... that the facts I
~~:: :;:! ~1lZ - beUef.
TAXP~ATURE
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COMMONWEALTH OF PENNSYLVANIA
J 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
LOOKER BRIAN B
4MOYALN
SANTA FE, ME 87508
__u_n_ fold
ESTATE INFORMATION: SSN: 172-01-5053
FILE NUMBER: 2106-1131
DECEDENT NAME: LOOKER JACOB B
DA TE OF PAYMENT: 12/21/2006
POSTMARK DATE: 12/14/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/15/2006
NO. CD 007594
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $406.27
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$406.27
REMARKS:
CHECK#1585
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS