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Home My WebLink About12-05-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: BROWN KRISTIN A 228 NORTH RACE STREET MIDDLETOWN, PA 17057 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 015286 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: SSN: zoo-3o-433 FILE NUMBER: 211 1-0083 DECEDENT NAME: POGUE JUDITH E DATE OF PAYMENT: 12/05/201 1 POSTMARK DATE: 1 2/03/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 1 1 /201 1 11003592 ~ 52,200.35 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 475 INITIALS: DMB RECEIVED BY: 52,200.35 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS o~, PENNSYLVANIA INHERITANCE TAX (fir INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES 'r-St~~~ ~ ~k~+r ~,lr FILE N0. 21 11-QO$3 PO BOX 280601 ~/ ~ HARRISBURG PA 17128-0601 ~nS+.~Van~a ~ AND ACN 11003592 ,~a6sTrleNroFnEVEnrue- - ~ TAXPAYER RESPONSE DATE 11-08-2011 kEV-1543 EX RFP (05-11) CLERf r ORFH~;~1'~ COURT i.;l: EST. OF JUDITH E POGUE SSN 204-30-7433 DATE OF DEATH 01-11-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: KRISTIN A BROWN REGISTER OF WILLS 228 N RACE ST 1 COURTHOUSE SQUARE MIDDLETOWN PA 17057-2242 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 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 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, Dlease 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 BELOYI * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 12125017180b Date O1 - 11 -2011 ro ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 195,586 46 payment to the Register of Wills. Make check . payable to "Register of Wills, Agent". Percent Taxable X 25.000 Amount Subject t0 $ Tax 48,896 62 NOTE: If tax payments are made within three . months of the decedent's date of death, Tax Rate )( . 0 4 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 2,200.35 Any inheritance tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 \ U O SP D LL SU I N F SCI T AS\ SNT A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK 0 N E 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 L 0 C K ~ g. ~ 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 ~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: ~ ,~ ~iCA~ ~£„~ ONLY~° ~~A,z 2 ~ 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 $ \u 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ b 7. Tax Rate 7 X 7 8. Tax Due g $ ~~ $ ~~ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT Parn IVINL fencer on Line 5 of fax Computation) S Under penalties of perjury, I declare that the facts I reported above'a7re true, correct and complete to the best of my knowledge and belief. HOME C l~ ) ~~ - WORK ( ~( ) _ T PAYER SIGNATURE TELEPHONE NUMBER D T ~rr - J ~}['~ ~~~.E ~''! (?fib J[~j' lJl"t~',i ~Jh ~~~V~l l C-~~1 _ . ~' ~ PA N y ~-z~ ~ ~~ ~~~ ~ ~ 0 N N N - ~,r e' Fs, ~_ U ~ ~ 5 a ~~ V' W (rn~~ l' j:~ r Ii,~j r ~n , ~~~ ~ /. f II#~ ~:~ ~s F•..t ::~ p.;s (,~ i s . IF :. h ,, ~••E . £.:9 ; _' t ~ USA F~'CI.A55 FO ~.. i' r.