HomeMy WebLinkAbout11-23-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-96)
NO. CD 015247
POGUE DAVID J
1201 SCENERY DR
MECHANICSBURG, PA 17050
toa
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11003593 ( 52,200.35
ESTATE INFORMATION: SSN: 204-30-7433
FILE NUMBER: 2111-0083
DECEDENT NAME: POGUE JUDITH E
DATE OF PAYMENT: 11 / 23/ 2011
POSTMARK DATE: 11 /22/2011
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 11 / 2011
REMARKS:
TOTAL AMOUNT PAID:
52,200.35
CHECK# 3464
INITIALS: HMW
sEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 penns~
HARRISBURG PA 17128-0601 DEPxnn4ENS. E~(ENUE
REV-1543 E% ,Ljy`j {?,. ~,
DAVID J POGUE
1201 SCENERY DR
'ENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 11-0083
(~L _~-, AND . ACN 11003593
~ ~ `~'~ ~~(XPAYER RESPONSE
°.Jfi i C DATE 11-08-2011
i'(1i! ~~ ~3 F I~~
CL~~K C~
GRPNF;~`S C~JUr~T
CUN~~~=~L,n~D C~) PA
MECHANICSB.UR.6 PA 17050-1942
EST. OF JUDITH E POGUE
SSN 204-30-7433
DATE OF DEATH o1-11-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
SUN LIFE FINANCIAL IRA provided the department with the informatign below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a ,point o-iner/beneficiary of this account. It you are-the SpoYSe of the
deceased aotl Bny'aarount other than zero is reflected below on the Potehttel Tax Due line, note no tax may be due: but- ou must
notify the dapartment of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" 1n PART 2.
If you believe 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. Please call 717-787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT IN3TRUCTION3
Account- No. 121250171806 Date 01-11-2011 To ensure proper credit to the account, two
Established copies of this notice oust accoapsny
Account Balance 195 586
46 pavaent to thr Reeistsr of Wills. Nake check
"
.
~ payable to
Rapistsr of Wills, Apent".
Percent Taxable X 25.000
Amount Subject to Tax
$
48
896
62 NOTE: If tax paYaents era aada within three
.
, aonths of the decedent's date of death,
Tax Rat• ~( , Olaf deduct a 5 percent discount on the tax due.
Potential Tax Duo
~
2
200
35 Ary inheritance tax dw will beeoas delinquent
.
, nine aonths after the Bete of death...
A. '1~1 The-above inforaation and tax due is correct. °'
~y Resit Dayaant to th• Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or return this notice to the Register b# Wills and
an official assessaent will be issued by the PA Departaent of Revenue.
0 N E
BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
D NL Y filed by the estate representative.
C. ~ The above inforaa ion is incorrect and/or debts and deductions were paid.
Coaplete PART 2~ and/or PART 3~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN. - CALCULATION
LINE 1. Data Established
2. Account Balance
3, Percent Tixahle_ _
4. Aaount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rat•
e. Tax Dua
OF TAX ON JOINT/TRUST ACCOUNTS
i
2 ~
3 X
4 ~
5
6
7 X
8 S
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
UndAir pprX#x#ies of perjury, I declare that #ha-facts I reporti'd `above arp true^',~ cpo/rr•ac'7t and
coa~-li'C1i'" a st of a:y 'knowledge and belief. HOME C~ r~ ) ! ` V ( ~ Q~
WORK C ): ~1i-1~-~~
TA L ATU TELEPHONE NUMBER DATE
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