HomeMy WebLinkAbout03-29-11 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 014212
BEATY PATRICK T
205 WEST MAIN ST
SHIREMANSTOWN, PA 1 701 1-6331
-------- fold
ACN
ASSESSMENT
CONTROL
NUMBER
RE\/-1162 EX~11-96)
AMOUNT
ESTATE INFORMATION: Ss-v: 205-22-7339
FILE NUMBER: 21 1 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
REMARKS:
SEAL
CHECK# 21 1
10162921 ~ $120.50
TOTAL AMOUNT PAID:
S 120.50
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STF-ASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLWANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21~~ 1" ~y~ ~ ~'
BUREAU OF INDIVIDUAL TAXES
Po Box 280601 ~' `" ~ AXPAYER RESPONSE ACN 10162921
HARRISBURG PA 17128-0601 ~! ~ ~ DATE 11-03-2010
~ _ ~_.~.J
REV-1543 EX AFP (08-08)
PATRICK T BEATY
205 W MAIN ST
SHIREMANSTOWN
. ~ 1
~L.Ei~'rC ~-~:-
PA 17011-6331
EST. OF JOHIJ J BEATY
SSN 205-22-7339
DATE OF DEATH 10-13-2010
COUNTY CUM$ERLAND
REMIT PAYMENT AND FOR M:3 T0:
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, 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. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8596763246-S4 Date 02-20-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance $ 5, 355.50 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax $ NOTE: If tax payments area made within three
2, 677 • 75 months of the decedent's elate of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due ~` 120.50 nine months after the date of death.
PART TAXPAYER RESPONSE
1
FAILU~iZ~\T' ~SPD~ .1'~~~~ R~E,'. \ \~!~ A~FICI~AJ.. TAX ASSESSMENT
~~
A. (-~e above information and tax due is correct.
LLJJ 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 R~agister 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 ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY
A~
relationship to decedent: ~~
~
PA DEPARTMENT OF RFVEN
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
L.itvE
i.
Daie c5idt~ilsi)ed 1
1 ,_,
2. Account Balance 2 $ 2 "
3. Percent Taxable 3 X 3 \
4. Amount Subject to Tax 4 $ ~ '
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 6 ~~"'°\
7. Tax Rate 7 X 7 ~~
8. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complet to the best of my knowledge and belief . HOME C ' ~
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DATE
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