HomeMy WebLinkAbout03-21-07 (2)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
.......-..M.. "
~
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 07-0151
07111266
03-16-2007
REV-1543 EX AFP (09-00>
EST. OF ELNORA E HAKE
5.5. NO. 191-18-3999
DATE OF DEATH 02-03-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
IXI SAVINGS
o CHECKING
o TRUST
o CERTIF.
LuGl Hf\R 2\ PI"\ \: 50
Qxb'()E.~~
CLI-nl
r,t:>"
Or'. ,-" '.." r',
'iWrC,"!
CU'
&aBETTE LARSON
826 ACRI RD
MECHANICSBURG PA 17050
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
BELCO COMMUNITY CU has provided the Deparhent with the inforllation 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 inforllation is incorrect, please obtain written correction froll 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 COllllonwealth
of Pennsylvania. Qu.....Uons ...y b" ;-ns.",red hy caVing (71 n 787-8!27.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 851768
Date 09-13-2005
Established
To insure proper credit to your account, two
(2) copies of this notice IIust accoIIPanv your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
[!]
36,935.59
X 50.000
18,467.80
X .045
831.05
TAXPAYER RESPONSE
NOTE: If tax paYllents are IIade within three
(3) IIonths of the decedent's date of death,
you IIay deduct a 5% discount of the tax due.
Any inheritance tax due will becolle delinquent
nine (9) .onths after the date of death.
A. ~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 IIay check box "A" and return this notice to the Register of
Wills and an official asses silent will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. c=l 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. c=l The above information is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART ~ and/or PART ~ below.
PART
I!l
TAX
If you indicate a different tax rate, please state your
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
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
PART
[!]
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
.
TOTAL (Enter on Line 5 of Tax Computation)
and
have reported above are true, correct
HOME CLl,) 1~~-~(O
WORK C ) ~ t
TELEPHONE NUMBER
Under penalties of perjury, I declare that the facts I
~~~~~~kn..'.... .n. b.".f.
~-\9t~o'1,
DATE
C
I