HomeMy WebLinkAbout07-18-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
SHUGHART RICHARD L
4 TODD CIRCLE
APT B
CARLISLE, PA 17013
NO. CD 014721
- fold
ESTATE INFORMATION: Ssly: ~ 62-22-3230
FILE NUMBER: 2'11 1-0791
DECEDENT NAME: SHUGHART MARGARET K
DATE OF PAYMENT: 07/ 1 8/201 1
POSTMARK DATE: 07/ 1 3/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/31 /201 0
1 1 141789 J $1 19.72
REV-1162 EX(11-96)
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 1779
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---------- --------
INITIALS: DB
RECEIVED BY:
$1 19.72
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~~, PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES
Po sox 2so6o1 Pennsylvania AND
HARRISBURG PA 17128-0601 J, } t _~~ ~ ~ * * ~ ~E~~S~ ~D f ~~
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TAX
FILE N0. 21 - ~~ "~~`~~
ACN 11141789
~E DATE 07-05-2011
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OJPPNA~.J!'~ ~;~~.}RT
RICHARI~1~~'}~H'F!"fj . PA.
4 TODD CIR APT
CARLISLE PA 17013-3576
EST. OF MARGARET K SHUGHART
SSN 162-22-3230
DATE OF DEATH 12-31-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
CITIZENS BANK OF PENNSYLVANIA provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If y OU are the SpoUSe of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, pease obtain written correct~en from the f;nancial institution, attach a copy to t M s form and i,eturn
it to the above address. Please call 717-787-8327 wi*,:h questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6100731855 Date 06-06-1966 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 5 ~ 320. $2 payment to the Register of Wills. Make check
~` payable to "Register of Wills, Agent .
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 2 ~ 660.41 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 $ 119.72 nine months after the date of death.
PART TAXPAYER RESPONSE
~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
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 return this notice to the Register of Wills and
0 N E an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ lfhe above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y 1`iled by the estate representative.
C. ~ lfhe above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~ and/or PART IJ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ $
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID F'AYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true, correct nd
complete to the best of my knowl a and belief. ~~
HOME C ~/~ ) i-'~'
AXPA R SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) $