HomeMy WebLinkAbout07-18-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
BEAGLE RICHARD B MD
201 WATERFORD WAY
LEBANON, PA 17042
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 014720
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: ssN: ~ 98-32-8788
FILE NUMBER: 211 1 -0425
DECEDENT NAME: BEAGLE HILDA J
DATE OF PAYMENT: 07/ 1 8/201 1
POSTMARK DATE: 07/ 15/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 03/ 30/ 201 1
REMARKS:
CHECK# 2307
SEAL
11126575 ~ $54.74
TOTAL AMOUNT PAID:
INITIALS: DB
554.74
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL T~~~~~w,.,.' ~~•
PO BOX 280601 ~ , _f_;~._~~f~.~~' '
HARRISBURG PA 17128-06 .}, _,~,,;: '
L. ~
REV-1543 EX AFP (OB-08)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 --~~ '~~~
ACN 11126575
DATE 04-19-2011
CLERK QF
ORPHAN'S COURT
CItMF~~ ~!..,4~~f ~ C;~. , PA
RICHARD BEAGLE
201 WATERFORD WAY
LEBANON PA 17042
EST. OF HILDA BEAGLE
SSN 198-32-8788
DATE OF DEATH 03-30-2011
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 F CU 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 (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 208996-05 Date 09-01-2001 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 7 ~ 298.96 payment to the Register of Wills. Make check
payable to Register of Wills, Agent .
Percent Taxable X lb .667
NOTE: If tax payments are made within three
Amount Subject to Tax $` 1 ~ 216.52 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 $ 54.74 nine months after the date of death.
PART TAXPAYER RESPONSE
1
AIL~~~~' RfSPA~I~~°WILL RESULT I`~ AN f~~~T~CIAL TAX ASS~S~MfNT
A. ~ The above information and tax due is correct.
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 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 estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART IJ below.
PART If indicating a different tax rate, please state D~~~J4L USE„ pNLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X ~
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
c m~ to t t est of owledge and belief . HOME (1 ~1 ) e~-1 ~ •-~p~"-j ~
W O R K C~l C •?
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~AXPAY R SIGNAT
TELEPHONE NUMBER D TE
TOTAL (Enter on Line 5 of Tax Computation) S
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