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Home My WebLink About01-04-07 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 FITZWATER TERESA 183 HillTOP VIEW WAY ELlZABETHTOWN, PA 17022 nn_h_ fold ESTATE INFORMATION: SSN: 164-30-2957 FILE NUMBER: 2107-0005 DECEDENT NAME: MADDEN PHilLIP P DA TE OF PAYMENT: 01/04/2007 POSTMARK DATE: 1 2/30/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/02/2006 NO. CD 007640 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06161733 I $1,500.31 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2853 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS $1,500.31 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, ,en -Q:b5 06161733 12-15-2006 REY-154S EXAF~ 109-00> TERESA FITZWATER c/o 733 OLD SLVR SPG RD MECHANICSBURG PA 17055 2"01JR~1 4 PH 1:34 U Fd', - EST. OF PHILLIP P MADDEN . ..,i ("'\- S. S. NO. 164-30-2957 CLEht\ I,r, DATE OF DEATH 11-02-2006 ORPlJ"','I,,',\,,j',.',',', ."('\ ..l)T C\J~./Inf'_!,' ,),--,I,it \ ":',tPOUNTY CUMBR~:~:~~YMENT AND REGISTER OF WILLS CUMBERLAND CO COURT CARLISLE, PA 17013 TYPE OF ACCOUNT D SAVINGS D CHECKING OCI TRUST D CERTIF. FORMS TO: HOUSE FULTON BANK has provided the Departllent with the inforllation 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 inforllation is incorrect, please obtein written correction froll the financial institution, attach a copy to this forll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CDllllonwealth of Pennsylvania. Questions lIay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 018-0221131 Date 12-07-2004 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 100,021.54 33.333 33,340.18 .15 5,001.03 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accollpany your paYllent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax paYllants are lIade within three (3) lIonths of the decedent's date of death, you lIay deduct a 5~ discount of the tax due. Any inheritance tax due will becolle delinquent nine (9) lIonths after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above inforllation and tax due is correct. 1. You lIay choose to rellit paYllent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you lIay check box "A" and return this notice to the Register of Wills and an official assesSllent will be issued by the PA Departllent 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 inforllation is incorrect and/or dabts and deductions were paid by you. You IIUSt cOllplete PART ~ and/or PART ~ below. PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART If you indicate a different tax rate,.please state your [!] relationship to decedent: .-I n .I J 0 h::tf:: r TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 r~ .' (j 7 10/ 00 t/ 2. Account Balance 2 Loa.., ().;).L- 5"j, 3. Percent Taxable 3 X 33 , ;:s 33 4. Allount Subject to Tax 4 -33 5tfo I I 8 s. Debts and Deductions S 6. Allount Taxable 6 7. Tex Rate 7 X 8. Tax Due 8 8~3fO. I' .045 /50013' PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on line S of Tax COllputation) of perjury, I declare that the facts I of IIY knowledge and belief. HOME ~ I $ are true, correct and lOr? 06 T r~ I '~d L.::J p, c:i (1:=,' i 0, -E' "., i '.." ,~. , ",1 ~ ...,J t'. 'It rl ( l a. a. l.D g tt :> to N i,.'1 U <1-04 LU (t' 0 ct 0:( ~ ;:r; J < l I I \ '/ i t ) N N ;.,1'2 ..~.... ~ ~ ~ ~ t:l. .t:l.!::l cf ,~;;. ~ '.. Q,.s e~;s "::::,8 f-o:I:~ uS M .... ~~fil ~ "'":: ~ -: ~ ::: ~ ~ -:: -:: ~ :::::: 1 ~ ::::: ~ ~ ... ~ ~ - 1 :::::::: -: ... - -~~ ~ ~ ~ ~ ~Lf .: ';~ !~\j ~ 8~=:i r- (.) = = C'J ..... .,.., () u () I.n .::' ..... .... ,..;. .,.., () 1''' .,.., .." ",