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Home My WebLink About11-22-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015241 BROWN EMILY 124 1 /2 E HIGH STREET HUMMELSTOWN, PA 17036 foltl ESTATE INFORMATION: ssN: 204-30-7433 FILE NUMBER: 211 1-0083 DECEDENT NAME: POGUE JUDITH E DATE OF PAYMENT: 1 1 /22/201 1 POSTMARK DATE: 1 1 /21 /201 1 couNTY: CUMBERLAND DATE OF DEATH: 01 / 1 1 /201 1 REMARKS: ACN ASSESSMENT CONTROL NUMBER REV-1162 EXI11-961 AMOUNT 11003604 ~ 5193.93 TOTAL AMOUNT PAID: 5193.93 CHECK# 496 INITIALS: DMB SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280b01 HARRISBURG PA 17128-0601 i Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX RFP (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0083 AND ACN 11003604 TAXPAYER RESPONSE DATE 11-08-2011 EST. OF JUDITH E POGUE SSN 204-30-7433 DATE OF DEATH 01-11-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: NOAH A BROWN REGISTER OF WILLS 124 1/2 E HIGH ST 1 COURTHOUSE SQUARE HUMMELSTOWN PA 17036-2303 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. LINCOLN 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 ownerfbeneficiary of this account. If you 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, please obtain written correction from the financial institution, attach a copy to this farm 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 INSTRUCTIONS Account No. 924473096 Date 01'11-2011 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register ofi Wills. Make check Account Balance 4,309.57 payable to "Register of Wills, Agent". Percent Taxable )( 100.00 NOTE: If tax payments are made within three Amount Subject t0 TaX ~` 4,309.57 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 $ 193.93 nine months after the date of death. PARr TAXPAYER RESPONSE r ~ . Ytl+ FCi~[1N~1 1 1" at` Its(' T-1 11 <~T~7,A1 TAX SS1+fEt'lY CHECK C ONE BLOCK ONLY The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 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 a relationship to decedent: TAX RETURN ~~~.. ~~ O~F I~AL ~S£~~ ONLY' [~~AF PA DEPARTMENT ~OF REYEt~UE - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 1 2 $ 3 X 4 5 - 6 $ 7 X 8 $ 1 2 3 ` 4 ,~ 6 7 6 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and compl to t the best of my knowledge and belief. HOME C ~ ~ i WORK ( ) 2 -rJ' I PA R SIGNATURE TELEPHONE NUMB R AT TOTAL CEnter on Line 5 of Tax Computation) 8 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BROWN EMILY 124 1 /2 E HIGH STREET HUMMELSTOWN, PA 17036 fold ESTATE INFORMATION: sSN: 204-30-7433 FILE NUMBER: 211 1-0083 DECEDENT NAME: POGUE JUDITH E DATE OF PAYMENT: 1 1 /22/201 1 POSTMARK DATE: 1 1 /21 /201 1 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 1 1 /201 1 REMARKS: SEAL CHECK# 495 REV-1162EX(11-961 NO. CD 015242 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11003597 ~ 5440.07 1 TOTAL AMOUNT PAID: 5440.07 INITIALS: DMB RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ~ FILE N0. 21 11-00$3 PD eox zso6ol pennsylvanla AND ACN 11003597 HARRISBURG PA 17128-0601 DEPARTMENTOFREVENUE TAXPAYER RESPONSE DATE 11-08-2011 REV-1543 EX AFP (05-11) TYPE OF ACCOUNT EST. OF JUDITH E POGUE ^ snvINGs SSN 204-30-7433 ^ CHECKING DATE OF DEATH 01-11-2011 ^ TRUST COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FORMS T0: NOAH A BROWN REGISTER OF WILLS 124 1/2 E HIGH ST 1 COURTHOUSE SgUARE HUMMELSTOWN PA 17036-2303 CARLISLE PA 17013 SUN LIFE FINANCIAL IRA 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 y0U are the Sp0U5e 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, 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 INSTRUCTIONS Account No. 121250171806 Date 01 - 11 -2011 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 9,779.32 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax $ 9, 779.32 months of the decedent's date of death, Taz Rate )( .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 440.07 nine months after the date of death. P~T TAXPAYER RESPONSE ~ ~TO; ~ LL . IN FI S SM T ,,,aaa___... _ 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 zind 0 N E 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 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 RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Porcant Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due ~O\° FI LASE ~NL PA DEPARTI4ENT OF REVENUE ~~ OF TAX ON JOINT/TRUST ACCOUNTS PAD 1 2 $ 3 X 4 +fi 5 6 7 X B $ 1 2 ~. 3 4 5 6 7 g ~~~ ~~~ ~ ~ ~~o PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, ~ctorrect and comp to the best of my knowledge and belief. HOME C ~ ) U lj: WORK C ~~ ) ~ ~ AX ER SIGNATURE TELEPHONE NUMBER ~ D T IUTAL cEnter on Line 5 of Tax Computation) S _~ _ 7 A R ~{ b3A37jOi. 5 ~ 1"L'I b5~ ~ ~ :4 4i ~{ 4 ~ t ~~~ ~ t ~ r ~~' .t x ? ~ ~ ~~ yi ,e ti "~~~~~ ~~{~ Y- i fi ~` s tip'` } ; ~i 44- 4k-" ii ;.i b% Vie? :P~: :~~ e`+; e ~ ~" jitY v~" F J yy ~~ Min. :vy &~. .~ J r~ 3 `~ ~~ t.::l ~~ ~ ~~ ~ ~ ~' ~ .~ -a- ~ ~ a ._- U r.. ~~ s. ;:~ 3 ~ ~: 2~ a ~ r r :~ ~M ~~ y ~... .,.~