HomeMy WebLinkAbout07-07-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0 601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 01 1454
HINTON HAROLD H
815 ACRI ROAD
MECHANICSBURG, PA 17050
fold
ESTATE INFORMATION: ssN: 159-20-0919
FILE NUMBER: 2109-0627
DECEDENT NAME: HINTON HAROLD H
DATE OF PAYMENT: 07/07/2009
POSTMARK DATE: 07/06/2009
couNTY: CUMBERLAND
DATE OF DEATH: 01 / 1 3/2009
REMARKS:
CHECK# 641
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
091 17312 ~ 513.20
TOTAL AMOUNT PAID: 513.20
INITIALS: AJW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AN D
PO BDX 288601
HARRISBURG PA I71z8-B6o1 TAXPAY E R R E S P O N S E
REV-1543 EX AFP (OB-OB)
F I L E N 0. 21 ~C1 ~ ~'~~
ACN 09117312
DATE 03-18-2009
HAROLD N HINTON
815 ACRI RD
MECHANICSBURG PA 17050-2231
EST. OF HAROLD H HINTON
SSN 159-20-0919
DATE OF DEATH 01-13-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account.
If you feel the 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
Pennsyivania, please call (i17) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0159200919-S4 Date 12-07-1998
To ensure proper credit to the account, two
Established copie f th"
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
rwKi
0
CHECK
C ONE
BLOCK
ONLY
$ 586.45
X 50.000
$ 293.23
X .045
$ 13.20
TAXPAYER RESPON;
E
FAILURE TO RESPOND WILL RESULT TN AN OFFICIAL TAX ASSE'S~~h}~
A. ^ The above information and tax due is correct. -.-{ '~
Remit payment to the Register of Wills with two copies of this notice t~btain
a discount or avoid interest, or check box "A" and return this notice to the Register(,glf
Wills and an official assessment will be issued by the PA Department of Revenue.
-.
_ _~
'":`t
The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3^ below.
r,arti •~ inuicacing a airferent tax rate, please state
relationship to decedent:
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
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
3 X
4 +~
5
6 +fi
~ X
8 $
s o is notice must accompany
payment to the Register of Wills. Make check
payable to "Register of Wills, R~nt".
a
NOTE: If tax pay re made`ofithin t~ne.e '
months of the dece date o ath t
deduct a 5 percent- - ~ on tax db® --z
Any Inheritance Taxx11 Qi11 become del~hqueiTL
nine months after _ ~of de~~. t ~? :°
PAD
1
2
3
4
5
6
7
8
PART
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) g
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
compl to to th best of my knowledge and belief. HOME ( /~ ~ ~ 7 Z + - 3 ~ ~~
~~~` -~~~ WORK ~'~ I7 ~ ~~a -Fa ~ ~
TAXPAYER SIGNATURE ____ 7 S f S
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
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