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HomeMy WebLinkAbout06-01-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HAWKINS ANGEL D 5219 OLD LOHMAN RD JEFFERSON CITY, MO 65109-0326 -------- fold REV-1162 EX(11-96) NO. CD 014527 ACN ASSESSMENT AMOUNT CONTROL NUMBER 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# 106 1 1 126565 ~ S 199.98 TOTAL AMOUNT PAID: INITIALS: DB RECEIVED BY: $199.98 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV-1543 EX AFP PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE r...,., AN D ,,~. ~ ' ~~~`~~~ AYER RESPONSE FILE N0. 21 '" ~ ~ "~-~-~ ACN 11126565 DATE 04-19-2011 ##,, 1 .1 ~:~ ~ ~ ~U ' j ~~f,~~ ~ k . ~ -i EST . OF DAISY R HAWK I NS SSN 256-44-3829 (;~„ER~ QF DATE OF DEATH 04 - 04 - 2011 ~~~ ~~n~ ~~ COUNTY CUMBERLAND (~ ~,J~~~~~~~ t ~ , 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 FCU 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 C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 349203- 11 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 $ 8, 888 • 06 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 4,444.03 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 199.98 nine months after the date of death. PART TAXPAYER RESPONSE 0 Unde penaltie of perjury, I declare that the facts I have reported above are tru/e~, ci_orrect and co lete to a best o~ my knowledge and belief . HOME C~~ ) ~~ ~(!~ -~/'~ 7. WORK C ~ LHIC TOTAL (Enter on Line 5 of Tax Computation) S