HomeMy WebLinkAbout06-01-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HAWKINS ANGEL D
5219 OLD LOHMAN RD
JEFFERSON CITY, MO 65109-0326
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ESTATE INFORMATION: SSN: 256-44-3829
FILE NUMBER: 211 1-0457
DECEDENT NAME: HAWKINS DAISY REE
DATE OF PAYMENT: 06/01 /201 1
POSTMARK DATE: 05/12/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 04/05/201 1
REMARKS:
SEAL
CHECK# 107
REV-1162 EX(11-96)
N0. CD 014526
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11126564 ~ $560.58
TOTAL AMOUNT PAID:
INITIALS: DB
RECEIVED BY:
REGISTER OF WILLS
$560.58
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543 E% AFP (08-08)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
(__° ~ AND FILE N0. 21 ~ (`- ~-%~~~
,~ ~ ~ ~ TA,~,}~/,~,YER RESPONSE ACN 11126564
~~'~`~ -~' w'" DATE 04-19-2011
EST. OF DAISY R HAWKINS
~R~ ~ SSN 25b-44-3829
~P~~ S ~~J~'j DATE OF DEATH 0 4 - 0 4 - 2 011
~~~~~~ ~;(~„ ~ COUNTY C U M B E R L A N D
REMIT PAYMENT AND FORMS T0:
KEVIN G HAWKINS REGISTER OF WILLS
939 HERMAN DRIVE 1 COURTHOUSE SQUARE
MECHANICSBURG PA 17055 CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST F CU provided the Department with the information below, which has been used in calculating the
were a joint owner/beneficiary of this account.
t
d
potential tax due. Records indicate that
t en
,
at the death of the above-named dece
se obtain written correction from the
l you
financial institution, attach a copy to this form
,
If you feel the information is incorrec
and return it to the above address. This ea
p
account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717) 787-83?.7
BELOW * with questions.
SEE REVERSE SIDE FOR FILING
AND PAYMENT INSTRUCTIONS
COMPLETE PART 1
Account No. 349203-00 Date 02-13-2009 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 $ 24,914.73 payable to "Register of Wills, Agent".
Percent Taxable )( 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 12,457.37 months of the decedent's date of death,
045 deduct a 5 percent discount on the tax due.
Tax Rate )( . Any Inheritance Tax due will become delinquent
Potential Tax Due $ 560.58 nine months after the date of death.
TAXPAYER RESPONSE
PART
0
Under penalt'es of perjury, I declare that the facts I have reported above are~~22tr~~u~_e, correct and
plete t the b st of my knowledge and belief. HOME C~~3 ) i4J~~,~~
WORK C
P IGNATURE, TELEPHONE NUMBER DATE
IUTAL ~tnter ~n L111C :~ a,i pow u~Yw~ca~-"••- -