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HomeMy WebLinkAbout02-22-11COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT Of REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014042 HALL BEATRICE M 6 LANTERN LANE SHIPPENSBURG, PA 17257 ACN ASSESSMENT CONTROL NUMBER told ESTATE INFORMATION: ssN: i ~~-i s-~ 654 FILE NUMBER: 2110-1256 DECEDENT NAME: KIRKMAN HELEN B DATE OF PAYMENT: 02/22/201 1 POSTMARK DATE: 02/19/2011 COUNTY: CUMBERLAND DATE OF DEATH: 12/08/2010 REMARKS: BEATRICE HALL SEAL CHECK#1218 AMOUNT 1 1500145 ~ S 1, 715.88 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: 51, 715.88 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17125-6661 ~~ <x•eu rv~NFORMATION NOTICE lJ~ AND '.TAXPAYER RESPONSE C )(- FILE N0. 21 - tom" ~~~ ACN 11500145 DATE 01-19-2011 21~i 1 EB 22 Pi'112~ 4 CLERK QP pRpMAN'S CpURT Cl1M8ERLA~D C0 . PA BEATRICE M HALL 6 LANTERN LANE SHIPPENSBURG PA 17257 TYPE OF ACCOUNT EST. OF HELEN B KIRKMAN ® sECURiTY S.S. N0. 177-16-1654 ^ sec ACCT DATE OF DEATH 12-08-2010 ^ srocK COUNTY CUMBERLAND ^ BoNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 AMERIPRISE has provided the Departwent with the information listed below which has been used in cal culatinp the potential tax due. Their records indieats that at the tleath of the above decadent, you were a beneficiary of this asset. If you fuel this information is incorrect, please obtain written correction frog the transfer spent, ettaeh a coDY to this fon and return it to the above address. This account is taxable-Sn eeeordanc• with the Inheritance Tax Laws of the Commonwealth of Pennsylvenla. puestions may be answered by calling (717) 787.8327. COMPLETE PART 1 BELOW ~ r ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 15414262 7o insure proper credit to your account, two (2) copies of this notice must seeomparo your DOD Valuation 1 2 O 4 1 3 1 6 payment to the Resister of Wills. Make check " . r pavabl• tos Raaister of Wills, Agent". Percent Taxable X 33.333 NOTE: If tax payments era made within three Amount Subject to TeX 40, 137.32 (3) months of the decedent's date of death, Taz Rate x . 045 You may deduct a 5X discount of the tax due: Aro inheritance tax due will become delinquent Potential Tax Due 1~B06.18 nine C9) months after the dat• of death. P T TAXP YE RESPONSE © A. ^ Tha abora information and tax due is correct. 1. Yeu may choose to remit Deyment to the Raaister of Wills with two copies of this notice to obtain CHECK a discount or avoid interest. or you ^ay checc box "A" and return this notice to the Register of C 0 NE ~ Wills and en official assessment will be fssued by the PA Department of Revenue. BLOCK B. ^ Tha above asset has been or will be reported end tax paid with the Pennsylvania Inheritance Taz return ONLY to be filed by the decedent's representative. C. ^Tha above inf ormetion is incorrect and/or debts and deductions were paid by you. You must complete PART ^2 and/or PART ~ below. PART If you indicate a different tax rata, please stato your © relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) LINE 1. DOD Valuation 1 2. Percent Taxable 2 X 3. Amount Subject to Taz 3 4. Debts and Da duetions 4 5. Amount Taxable 5 6. Tax Rate 6 Y 7. Tax Due 7 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK C ) oG-Iq-mil/ +'~ Under penalties of pe rjuryr I decla ra that the facts I have reported above are truo, correct and complete to the besx of_my knowledge and belief. ,,,,.,~ I15A. FIRST-CLASS FORNFR s ~:' r ~' a ~.ab4 ~q+ F b N `J (_,..~ J ~ ~--` ~ o ~ ~ ~/J _, o w ~ ~ LL.I O ~ ~ ~'' ~ ~ ~ ~ ~ ~ v° ~, .~... v ~z~ ~~~~, ~'~ .,..F