HomeMy WebLinkAbout01-08-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280801
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HOCUTT KELLI A
2411 TRACY DRIVE
HARRISBURG, PA 17112
-------- fold
ESTATE INFORMATION: SSN: 164-30-2957
FILE NUMBER: 2107-0005
DECEDENT NAME: MADDEN PHILLIP P
DATE OF PAYMENT: 01/08/2007
POSTMARK DATE: 01/06/2007
COUNTY: CUMBERLAND
DA TE OF DEATH: 11/02/2006
NO. CD 007654
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
06161729 I $153.02
I
I
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I
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TOTAL AMOUNT PAID:
REMARI<S: HOCUTT KELLI A
HOCUTT ROSS E
CHECK# 2879
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$153.02
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 . 0'1- D())S
06161729
12-15-2006
REY-1545 EX AFP (D9-DDl
EST. OF PHILLIP P MADDEN
S.S. NO. 164-30-2957
DATE OF DEATH 11-02-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
IXJ TRUST
D CERTIF.
KELLI WHITLEY
C/O 733 OLD SLVR SPG RD
MECHANICSBURG PA 17055
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FUl TON 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 Pennsylvania. Questicns may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1818-38424 Date 05-29-1984
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
10,201.15
33.333
3,400.35
.15
510.05
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".
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
::!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] 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 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.
PAYEE
[2 ("I ','d
<:.. n
~tJ..oo. 3~
. 0 J/-.e;-
153./12
D~~1h~ND DEDUCTIONS CLAIMED
.. udO
PART If you indicate a different tax_ryate, p~~e state your
~ relationship to decedent: et.a.l~lt:1qf\
TAX RETURN - COMPUTATION OF TAX ON J~INT/TRUST ACCOUNTS
lINE 1. Date Established 1 _t::; .-::t '1- J'll'
2. Account Balance 2 10. .!JUJL I~<:
3. Percent Taxable 3 X '.33. 333
4. Allount Subject to Tax 4 .3 4-DD. 3S"
S. Debts and Deductions S
6. Allount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
PART
~
DATE PAID
~
DESCRIPTION
AMOUNT PAID
(Enter on line S of Tax COllputation)
I
$
(\-;-ilrH 1,1"\
Under penalties of perjury, I declare that the facts I
cOllplete to the best of IIY knowledge and belief.
Ku..L' a t-hI"JrH
TAVDAVE;D C::Tr-tJATIIPE;
have reported above are true, correct
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Marriage Certificate
(Duplicate)
License No. U-15-0314 2005
I,
REVEREND SHAUN HUGHES
h~eby certify
that on the
22ND davof JANUARY. 2005
at
HARRISBURG PA
ROSS EDWARD HOCUTT
and
KELLI ANN WHITLEY
were by me united in marriage, in ~cordance with License issued by the Clerk of the Orphans' Court
Division of the Court of Common Pleas of Dauphin County, Pennsylvania.
Certified from the record
JANUARY 24, 2005
~"'a. e.~if
Clerk of the drphans' Court Division
REVEREND SHAUN HUGHES
Officiant
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