HomeMy WebLinkAbout02-01-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
dUREA~ OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO.21-DlD-O~71
ACN 06133022
DATE 07-07-2006
RE'I-1545 .EX AFP 109-001
NANCY
5 CHANNEL
CARLISLE
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A 'CtARK
DR
EST. OF MARGARET J WEAVER
S.S. NO. 207-22-2193
DATE OF DEATH 05-05-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
[Xl CERTIF .
Fc8 - I PH 2: II
PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SOVEREIGN BANK has provided the Depart.ent with the infor.ation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this infor.ation 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 Com.onwealth
of Pennsylvania. Questions may be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1695331254 Date 01-16-2002
Established
x
12,338.96
50.000
6,169.48
.15
925.42
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must acco.pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
you may deduct a 57. discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
Tax
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above infor.ation and tax due is correct.
1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you .ay check box "A" and return this notice to the Register of
Wills and an official asses~ent will be issued by the PA Depart.ent of Revenue.
~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritanca Tax return
to be filed by the decedent's representative.
[] The above inforMation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below~
2
3
4
5
6
7
8
x
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date ~stablishea
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
:i.
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
$
I
TOTAL (Enter on Line 5 of Tax Computation)
complete
",-.
perjury, I declare that the facts I have reported above are true, correct and
my knowledge and belief.
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