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HomeMy WebLinkAbout04-13-11 (3)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 EX(11-96) NO. CD 014297 HUGHES ROBERT P 1732 WEST TRINDLE RD CARLISLE, PA 17015 -------- fold ACN ASSESSMENT AMOUNT CONTROL NUMBER ---------- -------- 11500755 ~ S38.75 ESTATE INFORMATION: ssrv: ooo-oo-oooo FILE NUMBER: 211 1-0445 DECEDENT NAME: HUGHES NEWTON S DATE OF PAYMENT: 04/ 1 3/201 1 POSTMARK DATE: 04/ 12/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 16/201 1 REMARKS: TOTAL AMOUNT PAID: $38.75 CHECK# 1273 INITIALS: DB SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REV EN F~,- _ BUREAU OF INDIVIDUA ~-Tr~4~(~5: ~ '~'~ (~ PO BOX 280601 r ``~ ~~ V HARRISBURG PA 17128-kQ¢QL ~ i !i t f~ .. _ ~,~ REV-1543A AFP (7-00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 °~ ~ I "~ ~~u ~j ACN 11500755 DATE 04-04-2011 TYPE OF ACCOUNT EST. OF NEWTON S HUGHES ^ SECURITY ~~~'RK ~r S . S . NO . 146 - 22 - 5851 X^ SEC ACCT (~ OF~'i-~~~~,~`S .;{ i~~j DATE OF DEATH O 1 - 16 - 2011 t/~1~'f ~,~-~'i ''''''_i ,r.y ^ STOCK ~ _~t-; "' ,~A COUNTY CUMBERLAND ^ BONDS ROBERT P HUGHES REMIT PAYMENT AND FORMS T0: 1732 WEST TRINDLE RD REGISTER OF WILLS CARLISLE PA 17015 1 COURTHOUSE SQUARE CARLISLE PA 17013 AMERIP RISE 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. 930066061043004 To insure proper credit to your account, two (2) copies of this notice must accompany your DOD Valuation 4,532.00 Payment to the Register of Wills. Make check Percent Taxable payable to: "Register of Wills, Agent". X 20.000 Amount Subject to Tax 906.40 NOTE: If tax payments are made within three (3) months of the decedent's date of death, Tax Rate X . 045 You may deduct a 5% discount of the tax due. Potential Tax Due 40.79 Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE FAILURE TU RESPOND ~LL.:~RESULT IN AN OFFICIAL TAX ASSESSMENT BASED flN THIS h10TICE 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 ^2 and/or PART ^ below. DADT rf •,n~~ .. .~: __i_ -- ~-- -'~~~~a~C d airrerent tax rate, please state your relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS) LINE 1. DOD Valuation 1 2. Percent Taxable 2 X 3. Amount Subject to Tax 3 4. Debts and Deductions q 5. Amount Taxable 5 6. Tax Rate 6X 7. Tax Due ~ PAR? DATE PAID PAYEE OFFICIAL USE ONLY ^ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 q 5 6 7 8 AIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of p jury, I eclare that the facts I have reported above a tr complete to the best of kn a belief. o rect and .HOME (7~~ )._~ `~ TAXPAYER SIGNATURE WORK ( ) TELEPHONE NUMBER DATE DEBTS AND DEDUCTIONS CL tfirttlapplrttt~l{t~ftttjtttftttt((tttt{~ttt~Itt~+~,li~ ~{~s~tl i tt t 1 [ (1 [ 4 tl 11 !i it t ~ ~'J S> ~~ J ~ ( cz~ -v ~/ ~~ l rn ~ ~~m ~'~ AN ~ _> // ,/ ~t:: ~~~~ ~~ ~ ..,,:.~ _ ~ ~ +1~1Sfi•~iw. J _NY° + cM~fi~~'n:S.N,'s rye,.. r.. _~ _ P ~~,~ ::~ -~y1 --' -~ ~, / ~X t ~ - .. _ -~- ~~ .. `~~ ~._ "~~''J /Q~- ~ l ~~ ~I ~ 1 /~^~ ,~ ,,. ~4 {. ~., Y ~t Y X45 ..3'Y ~r.' r~y~ / ~~~ V ~J~ l.~ ~ _ . 'w..,: rr _