HomeMy WebLinkAbout01-03-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF .REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B060l
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* REVISED NOTICE * * *
FILE NO. 21
ACN 06156615
DATE 12-06-2006
*
REV-1545 EX lFP 109-001
EST. OF WILLIAM D HARDIN
S.S. NO. 211-22-1496
DATE OF DEATH 10-03-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
[X] TRUST
o CERTIF .
SUSAN L HARDIN
1605 SUMMIT AVE
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SOVEREIGN 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 incorrect, 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 pgnnsylvania. QUQst:ions lIlay baanswored by calling (717) 787--832.7'.
COMPLETE PART 1 BELOW . . . 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
(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
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
[!I
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
!if The above information and tax due is correct. . ..0;; 0 ~ :u
1. You may choose to remit payment to the Register of Wills with two copies'-11fJ::Itlis notie.... to oblBi~:LI
a discount or avoid interest, or you may check box "A" and return this notii!ii,.tq the g.gister'.-of ;-)
Wills and an official assessment will be issued by the PA Department of R.."cb:J~ :;;:::: ., '~_i~
~~': C;=;, ':-}
o The abo~e asset has been or will be repor~ed and tax paid with the PennsYlvaliia-)~ritarCblt Tax ""wrn..!
to be flIed by the decedent's representatIve. ';, ......' '1._-)
o The above information is incorrect and/or debts and deductions were paid by~~j ~
You must complete PART 0 and/or PART @] below._ ..-:C~
.j
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
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
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3
4
5
6
7
8
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I
comple~e to the best of my knowledge and belief.
__~~Pl~.~
I
$
have reported above
HOME (31t) )'H~
WORK ( )
T~I~PHnNF NUMBER
are true, correct and
c)lf( <I
/2(26/0(,
D TE'
q
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
HARDIN RICHARD D
3212 J ARROWHEAD CIRCLE
FAIRFAX, VA 22030
__un fold
ESTATE INFORMATION: SSN: 211-22-1496
FILE NUMBER: 2106-1161
DECEDENT NAME: HARDIN WilLIAM D
DATE OF PAYMENT: 01/03/2007
POSTMARK DATE: 01/03/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 10/03/2006
NO. CD 007632
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
06156615 I $703,79
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$703.79
REMARKS: HARDIN SUSAN l
CHECK# 501
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
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