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HomeMy WebLinkAbout06-01-11 (3)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX~11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014528 HAWKINS ANGEL D 5219 OLD LOHMAN RD JEFFERSON CITY, MO 65109-0326 - fold ACN ASSESSMENT AMOUNT CONTROL NUMBER 1 1 126566 ~ 5131.17 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: CHECK#105 SEAL TOTAL AMOUNT PAID: INITIALS: DB RECEIVED BY: REGISTER OF WILLS REGISTER OF WILLS $131.17 GLENDA EARNER STRASBAUGH PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES r1 C-~. PO BOX 280601 ~f ~{'-) i ~~-~~~ AND HARRISBURG PA 1712s-o6o1 ~~ ~, ,, ~,, AYER RESPONSE REV-1543 EX AFP (08-08) FILE N0. 21 - ~ ~ ' ~~ 7 ACN 1112b566 DATE 04-19-2011 Vt~l~n Ci~'~ COURT KEVIN G HAWKINS 939 HERMAN DRIVE MECHANICSBURG PA 17055 EST. OF DAISY R HAWKINS SSN 256-44-3829 DATE OF DEATH 04-04-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE 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 question. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 349203-01 Date 02-13-2009 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 5, 829.90 Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 2, 914.95 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 131.17 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 0 .~ A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of O N E Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O 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 relationship to decedent: TAX LINE RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Established 1 ~, 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 +fi 5. Debts and Deductions 5 6. Amount Taxable 6 $ ~ 7. Tax Rate ~ X 8. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I have reported above are true, correct and conyPlete to th best f,my knowledge and belief. ? HOME (J`~73 ) ~ ,~©`_/~ Ob '' L / ~ WORK t ~ T PAYER I URE TELEPHONE NUMBER - - - - - _ DATE ~~G~'=P~l~r~ ' ~-~--~C.~ C~ ~; , :. ~~'~ i JAN ~- ~ ~~. I I ~ ~~, Ct1MBF1~D CO w .~ ~ ~' # ~ --~ ~~ ~ ~ ~. ~.- . ~ ~ rµ..w V C~.l~ ...... wr ~..... ::.,. ~ ,,,,,,,, ._... ..... N \ ..».. \ ::,.. ~-- :... ..... .a~~:,,_ ~ j D ~~~ o p w ~ a 2 r w ~ ~ x O °' y ~ a 0 so 0 ,~ s r . ~. ~~~r ~. ?'+i' i /G „- li !} ~4 Y d} ;~~, ~i . :!,r; ~' . fea` w4 ~ ~t i""i' ~,~ ,. ~,~ ~. fia.. ~~:. ~~~ ;~ !+w ,..v.• 4 rt? ~. ~ ~5 ~$. ~, .,, :: aana ~' J~ ii `n « ~ -~'. ,~,~ .. ~,, ~r a °,~S°i~~' ,... v5n