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Home My WebLink About11-16-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KEATH EUGENE L 201 DENISON DR DAUPHIN, PA 17081-9358 ACN ASSESSMENT CONTROL NUMBER fob ESTATE INFORMATION: SSN: 204-30-7433 FILE NUMBER: 2111-0083 DECEDENT NAME: POGUE JUDITH E DATE OF PAYMENT: 11 / 16/ 2011 POSTMARK DATE: 11 /15/2011 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 11 /2011 REMARKS: SEAL CHECK# 1361 AMOUNT 11003594 ~ $880.14 11003601 ~ 5387.86 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: 5.1,268.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1182 EXI11-96) NO. CD 015214 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0083 BUREAU OF INDIVIDUAL TAXES PO BOX 280601 Pe 1)~: 11~`~ Of AND ACN 11003594 HARRISBURG PA lnza-ocol o~P o~4tEVEwu~;' ~ ~ TAXPAYER RESt~ONSE t~ DATE 11-08-2011 REV ~~7{"A~q L(~11) 4~:.s_.~.1 CLARK OF ORPHAN'S COURT CUMBF~La~iG CO. PA JEFFREY E KEATH 201 DENISON DR DAUPHIN PA 17018-9358 EST. OF JUDITH E POGUE SSN 204.-30-7433 DATE OF DEATH 01-11-2011 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 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 point owner/beneficiary of this account. If you are the spouse Of the deceased-and any'a~ouht other than zero is reflected below on the Potential Tax Due Sine, note no tax may be due, but You must notify the de~ertn~ent of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If yyou believe he 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 PARfi l BEtOW * SEE REVERSE SIDE FOR FILING AND PAYMENT-3NSTRUCTIONS - Account No. 121250171806 Date O1 -11 -2011 7o ensure. proper credit to the account, two Established copies of this notice oust accowpany payment to the Register of Wills. Meke check Account Balance 195,586.4( payable to ''Register of Wills, Agent". Percent Taxable. X 10.000 NOTE: If tax payments sre made within three Amount Subieet to Tax ~ 19,558.65 ronths of the decedent's date of death, Tax Rate )( , Q45 deduct a 5 percent discount on the tax due. Argr inheritance tax_due will become delinquent Potential Tax Due ~ 880.14 nine aonths after the date of death. PART TAXPAYER RESPONSE A. ~ The above infonation 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 CHECK an official assessment will be issued by the PA Departwent of Revenue. C ONE BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 NL 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 OF TAX ON JDINT/TRUST ACCOUNTS LINE 1. Date Established 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 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax CoaFpatation) ~ Under penalties of perfury, Y ~ doclare that #h®-facts I reported above are truo, correct and •p a to the bast of y kno wledge ahd belief. HOME C . . WORK C j . ) UR TAX A R I TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~ PENNSYLVANIA INHERITANCE TAX INFO~tMATION NOTICE FILE N0. 2I 11'=0083 fl~ ~~~ t1f AND ACN 1/003601 wEH~~ . ,, C TAXPAYER RESPONSE DATE 11-08-2011 46s nc~gFPt~uE ia7 `~;'~`.~.'J w( ~ ~ f~~ ~ ~ ~' ~~~ ~ CI~E~K GF ~~``Q`RP ''}~~t'S~ COUNT A 41J~~~~lt'vv~ ~~.. QA JEFFREY E KEATH 201 DENISON DR DAUPHIN PA 17018-9358 EST. OF JUDITH E POGUE SSN 204-30-7433 DATE OF DEATH. 01-1L-2011 COUNTY., CUMBERLAND REMIT PAYMENT AND FORMS 70: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17b13 TYPE OF ACCOUNT SAYINGS CHECKING ~, TRUST CERTIF. LINCOLN FINANCIAL ANNUITY 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 ownerlbeneficiary of this account. If you are th! SpOtiSe Of the deceased and any aBmunt other than zero is reflected below on the Potential Tax Due line, note no tax a+ay be due, but-y9v-gust notify the departBient-ot your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in•RART 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 thB.~oYe BcJdre~s. P1Basg call 717.-78748327 .with questions. _.: _ _ _ COMPLETE PARt 1 BELOW * SEE REVERSE SIDE- FOR FILING AND PAYMENT' iINSI'ttUCT`~ONS _ - ~' Account No. 92447309 Date 01-11- 2011 To ensuro proper credit 4o the account, two: Established copies of this notice rust accoapany Account Balance $(~ 141 , 33 payaent to the Register of Wills. Nake check $ payable to "Register of Wills, Agent". Percent Taxable X 10.000 Amount Subject to Tax $ 8,619.13 Tax Rata ~( .045 Potential Tax Due $ 387,86 P~T ~ TAXPAYER ~RES!'ON NOTE: If tax payments are made within three months of the decedent's date of destfi, deduct a 5 percent discount on the tax due. Any inheritance tax dus will becoao delfnauant nine aanths after the date of death. A. ~ Tha above inforaetion and tax tlue fs correct. Resit payaent to the,f~egister of Wills with two copies of this notice to obtain CHECK .~ a discount or avoid interest; or ra~urn'this 8 f „notice to the A Regiatar of Wills and C aN~ ~ an Of ici l assass~ent wi11.6e issued by the P Degartaent of Revenue. BLOCK H. ~ Ths above asset has been or will be reperted and tax pafd with the Pennsylvania inheritance tax return ONLY filed by the esthte representative. C. ~ The above infona ion is incorr t and/or debts and deductions were paid. Coagle'ta PART ~2 and/or PART below. PART If lndicot~ng a different tax rate, please state ~' °r`alatfdnship to decedent: TAX f RETtiitN - CALCULATION ' OF TAX ON JOINT/TRUST ACCOUNTS LINE i. Date Establish®d i 2. Account Balance 2 $ - _ _ 3,-Po"`fiAAf1`t _Tititiy513' - -- :., .S' -~- -. ----°-~ -- - __°..- . _._ 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 reported above are true, cgrract,and: compla,te to tb bast o knowledge and belief. HOME ( ) + . WORK C ) ` '~ TAX AVER IGNA U E TELEPHONE NUM E nerc _ _ _ ~ ~. ~g <: ~ ~ t ,~ ..~>q ~" ,~ ~_ t , ~ c n /O ~ A ~ ~.. ~( hp~ ~ c ~ ~~ p ~ ~ ~..a D f!~ w v3 ~ a~ n