HomeMy WebLinkAbout04-13-11 (2)COMMONWEALTH 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
REV-1162 EX111-96)
NO. CD 014296
HUGHES ROBERT P
1732 WEST TRINDLE RD
CARLISLE, PA 17015
-------- fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
11500750 ~ 5295.52
ESTATE INFORMATION: SSN: 000-00-0000
FILE NUMBER: 211 1-0445
DECEDENT NAME: HUGHES NEWTON S
DATE OF PAYMENT: 04/ 13/201 1
POSTMARK DATE: 04/ 12/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 16/201 1
REMARKS:
CHECK#1274
SEAL
TOTAL AMOUNT PAID:
5295.52
INITIALS: DB
RECEIVED BY: GLENDA EARNER RTR,o,RR01 Ir;f-~
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE i-{-!~~" __, ,,, ..L
BUREAU OF INDIVIDUAL TAXES r-~~'
PO BOX 280601 ~-
HARRISBURG PA 17128-0601 ~}'-,~ r
REV-1543A AFP (7-00)
INFORMATION NOTICE FILE N0. 21 ~~ ~ _~t~~~~
AND ACN 11500750
TAXPAYER RESPONSE
DATE 04-04-2011
g~ {{ P i .:
G~'~Nf P~`~ ~-' ~',Jf~T
~~~ .
ROBERT P HUGHES
1732 WEST TRINDLE R1)
CARLISLE PA 17015
TYPE OF ACCOUNT
EST. OF NEWTON S HUGHES ^ SECURITY
S.S. N0. 146-22-5851 X^ sEC ACCT
DATE OF DEATH O 1-16 - 2 011 ^ srocK
COUNTY CUMBERLAND ^ BONDS
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
AMERIPRISE 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 beneficiary of this asset.
If you feel this information is incorrect, please obtain written correction from the transfer agent, 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.
Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 930068932035004 To insure proper credit to your account, two
(2) copies of this notice must accompany your
5 6 3 . ( $ Payment to the Register of Wills. Make check
DOD Valuation 34, payable to: "Register of Wills, Agent".
Percent Taxable X 20.000
NOTE: If tax payments are made within three
Amount Subject to Tax 6,912.74 (3) months of the decedent's date of death,
Tax Rate X .045 you may deduct a 5% discount of the tax due.
Any inheritance tax due will become de:Linquent
Potential Tax Due 311 07 nine (9) months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND LL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. he 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
C H E C K a discount or avoid interest, or you may 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 decedent's representative.
C. ^ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART If you indicate a different tax rate, please state your {)FFICIAL U5E ONLY ^ AAF
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) PAD
LINE 1. DOD Valuation 1 1
2. Percent Taxable 2 X 2
3. Amount Subject to Tax 3 3
4. Debts and Deductions 4 - {~
5. Amount Taxable 5 5
6. Tax Rate 6 X ~
7. Tax Due 7 ~
8
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PArn
Under penalties of perjury,
complete to the best f my~ow
I declare that the facts I have reported above are true, correct and
dge and be~ HOME C )
i
Wf1RK ~ l
TAXPAYER SIGNATURE ~ TELEPHONE NUMBER
DATE
ivir~~ ~~n~er on Llne 5 OT IaX Computation) $