HomeMy WebLinkAbout02-15-07
COMMOItrIEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280'01
HARRISBURG, PA 17128-0601
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INFORMATION NOTICE
('( AND
i_I TAXPAYER RESPONSE
FILE NO. 21 .06 -1147
ACN 071D4409
DATE 02-05-2007
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EST. OF FRANCES T BRUNGARD
S.S. NO. 177-09-8483
DATE OF DEATH 12-02-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
[i] CHECKING
D TRUST
.' DCERTIF.
Z001 FEB 15 At1 9: 36
RUSSELL G BRUNGARD
7013 DORSEY RD
LAYTONSVILLE MD 20882
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CITIZENS BANK OF PA has provided the Depart.ent with the info~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 fro. the financial institution, attach a copy
to this fo~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~.onwealth
of Pennsylvenia. Que.tions aay be answered by calling (717l 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILINQ AND PAYMENT INSTRUCTIONS
Account No. 6205298736
Date
Established
05-21-2004
To insure proper credit to your account, two
(2) copies of this notice .ust acco.pany your
PllYllent to the Register of Wills. Make check ..;
pllYable tOI "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount SUbject to Tax
Tax Rate
Potential Tax Due
x
13,010.30
50.000
6,505.15
.045
292.73
TAXPAYER RESPONSE
NOTE I If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
YOU .1lY deduct a 5X discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
x
PART
[!]
I;Itrit;1~l::i.t:~r:I:;:Z:~~:~~~~:;lII~:j;tZll;l;~"J~i:j~~~:;:~~1i;j~~i:~;:i::~:;~;J;~:~;~:~;;00t~-:;ti:;'~<<:;~~r{1~~1
A. ~ The above info~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 assess.ent will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. [] The above asset has been or will be reported and tax paid with the PennsYlvania Inheritance Tax return
to be filed by the decedent's representative.
C. [] The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
DEBTS AND DEDUCTIONS CLAIMED
PART
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TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
LINE l. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. Amount SUbject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7
8. Tax Due 8
PART
~
DATE PAID PAYEE
x
x
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Co~put.tion)
.
of perjury, I declare that the facts
of my knowledge and belief.
have reported above are true, correct and
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TELEPHONE NUMBER DATE
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