HomeMy WebLinkAbout09-07-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
;ECEIVED FROM:
RICHARDS GORDON
131 TORY CIRCLE
ENOLA, PA 17025
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssN: 179-44-9399
FILE NUMBER: 211 1-0150
DECEDENT NAME: RICHARDS BETH ANN
DATE OF PAYMENT: 09/07/201 1
POSTMARK DATE: 09/06/201 1
COUNTY: CUMBERLAND
DATE OF DEATH : 01 / 23/ 201 1
REV-1162 EX(11-96)
N0. CD 014938
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11 106632 ~ $15.68
TOTAL AMOUNT PAID:
REMARKS: GORDON RICHARDS
CHECK# 1 131
SEAL
INITIALS: WZ
$15.68
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCF_
INFORMATION NOTICE
BUREItU OF INDIVIDUAL TAXES ~" "~~" - - AND
Po sox 280601 ~~ ~~~'~pAYER RESPONSE
HARRISBURG PA 17128-0601 .f
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REV-1543 EX AFP (08-OB)
TAXI
FILE N0. 21 ~'~~"' ~ ~ ~~
ACN 11106632
DATE 02-03-2011
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GORDON RICHARDS
131 TORY CIRCLE
ENOLA PA 17025
EST. OF BETH A RICHARDS
SSN 179-44-9399
DATE OF DEATH 01-24-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND f~ORMS 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 questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 7590 - 0 0 Date 11-13 -1964 To ensure proper credit to the account, two
Established copies of this notice must accompany
6 9 6 . $ 0 payment to the Register of Wills. Make check
Account Balance $ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 348.40 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $` 15 . b8 nine months after the date of death.
PART TAXPAYER RESPONSE
a ,~
A. he 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.
BLOC K g. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be tiled 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 RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINt i. gate Establishes 1 ~~~ ~~ ~ \ \
2. Account Balance 2 $ ~\
3. Percent Taxable 3 X ~~
4. Amount Subject to Tax 4
5. Debts and Deductions 5 - ~ .~
6. Amount Taxable 6 $ \ ~ \
7. Tax Rate 7 X ~~~.
8. Tax Due 8 $ \ \ ~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
com ete to the best of my knowledge and belief . HOME C-? ~,~ ) O7~ 13
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TAXPA ER SIGNATURE TELEPHONE NUMBER DATE ~
IUTAL ctnter on Line 5 of Tax Computation) S
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