HomeMy WebLinkAbout03-29-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BEATY PATRICK T
205 WEST MAIN ST
SHIREMANSTOWN, PA 1 701 1-6331
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ACN
ASSESSMENT
CONTROL
NUMBER
ESTATE INFORMATION: SSN: 205-22-7339
FILE NUMBER: 211 1-0408
DECEDENT NAME: BEATY JOHN J
DATE OF PAYMENT: 03/ 29/ 201 1
POSTMARK DATE: 03/28/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 10/13/2010
AMOUNT
10162920 ~ $1 12.82
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 212
$1 12.82
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX111-96)
NO. CD 01421 1
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
f- .AND
~~~ TAXPAYER RESPON:-E
FILE: N O. 21' ~ 1 ~' ~~ ~Q~
ACN 10162920
DATE: 11-03-2010
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PATRICK T BEATY
205 W MAIN ST
SHIREMANSTOWN PA 17011-6331
EST. OF JOHN J BEATY
SSN 205-22-7339
DATE OF DEATH 10-13-2o1a
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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, attache 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. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8596763246-S1 Date 02-20-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
0 1 4 .2 2 payment to the Register of Wills. Make check
Account Balance $ 5 ~ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 2 ~ 507.11 months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due ~` 112.82 nine months after the date of death.
PART TAXPAYER RESPONSE
,,
1
FAIt~~~N~"~~~5~~~~la~~~ ~~~ ~ A3'~ ~~FFICIAL T~lX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informs lon is incorr~ect and/or debts and deductions were paid.
Complete PART 2~ and/or PART f~ l below.
PART If indicating a different tax rate, please state '~
flFFiCIAL USE ONLY AAF~~<
a relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
Liivc i. i,aie tsiabiishea 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ C~
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ $
PART DEBTS AND DEDUGTIONS CLAIMED
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief . HOME C 7 ~ ~) ~ ~ ~ ~ /~ ~- a
'`-~r7 '~ ~ '~ WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) 5
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