HomeMy WebLinkAbout12-28-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HARDIN RICHARD D
3212 J ARROWHEAD CIRCLE
FAIRFAX, VA 22030
----~~-- fold
ESTATE INFORMATION: SSN: 211-22-1496
FILE NUMBER: 2106-1161
DECEDENT NAME: HARDIN WilLIAM D
DA TE OF PAYMENT: 12/28/2006
POSTMARK DATE: 1 2/28/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 10/03/2006
NO. CD 007623
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $668.79
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$668.79
REMARI(S: HARDIN RICHARD D
CHECI(# 0009
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
'*
'IE
REV-1545 EX AFP 109-00)
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REVISED NOTICE 'IE 'IE 'IE
FILE
ACN
DATE
NO. 21
06156614
12-06-2006
'IE
TYPE OF
ACCOUNT
o SAVINGS
o CHECKING
IX] TRUST
o CERTIF.
RICHARD D HARDIN
1605 SUMMIT AVE
CAMP HILL PA 17011
EST. OF WILLIAM D HARDIN
S.S. NO. 211-22-1496
DATE OF DEATH 10-03-2006
COUNTY CUMBERLAND N
C;:l
REMIT PA~,:~, AND FQBM" S TO
REGISTER OF <fI~;l.S CJ
CUMBERLAND CO:~, T ~USE
CARLISLE, PA 'lq~3 N
;:-!~ co
/......
c-
.- -~2J
'< (:-)
=~:::J W !-- (1
SOVEREIGN BANK has provided the Department with the information listed below which h~ o-den used in .<) .:<<)
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were e:3dint owner/~ficiary of<'
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, a~ch 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 Pgnns:vlusrai;:a. o.'.les'tions l!Ia~ be answored by callinSi (717) 787-8327.
.."
---
--
COMPLETE PART 1 BELOW 'IE 'IE 'IE SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1055539819 Date 09-15-2005
Established
x
31,279.46
50.000
15,639.73
.045
703.79
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) 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
NOTE: If tax payments are made within three
(3) months of the decedent.s date of death,
you ..ay deduct a 5;( discount of the tax due.
Any inheritance tax due will becDIIS delinquent
nine (9) months after the date of death.
Tax
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
~The above information and tax due is correct.
~ 1. You ..ay choose to remit pay..ent 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.
[] 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.
[] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[!]
TAX RETURN - COMPUTATION OF
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount Subject to Tax 4
S. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
$
perjury, I declare that the facts I
my knowledge and belief.
have reported above are true, correct and
HOME (703 ) q -'1Zt./L
WORK ( 7iJ 3 )'577 ~ddt>
TFIEPHONE NUMBER
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