HomeMy WebLinkAbout03-27-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG. PA 17128-0601
*'
INFOR ATION NOTICE
AND
TAXP YER RESPONSE
FILE
ACN
DATE
NO. 21 '2)1 \) ?- f"
07108363
03-01-2007
REV-1S"3 EX AFP (09-00)
OF DOROTHY J BOOSER
TYPE OF ACCOUNT
o SAVINGS
[i] CHECKING
o TRUST
o CERTIF.
REMIT PAYMENT AN>>~fORMS TO:
REGISTER Of WILLS 55
CUMBERLANi);c:m COU~ HOUSE
CARLISLE, 'p~ 17 0 1='~
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CHARLES R BOOSER
437 BETHANY DR
MECHANICSBURG PA 17055
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M & T BANK has provided the Departllent with he info...ation listed below whid:i ':MS been used in :.)
calculating the potential tax due. Their records indicate that at the deat of the above decedent. you were ~~oint ow~benefi~iary\ of
this account. If you feel this inforaation is incorrect. please obtain wri ten correction froa the financ~}. institutioeJ}attach a c~y
to this form and return it to the above address. This account is taxable 'n accordance with the Inheritance Tax Laws ot:jhe Coaaonwealth
of Pennsylvania. Questions aay be answered by calling (717) 787-8527.
COMPLETE PART 1 BELOW
Account NO. 16559479
. . . SEE REVERSE SIDE
FILING AND PAYMENT INSTRUCTIONS
Date
Established
To insure proper credit to your account. two
(2) copies of this notice aust accoapany your
payaent 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
1,036.40
X 50.00
518.20
X .04
23.32
NOTE: If tax payaents are aade within three
(3) months of the decedent's date of death.
you aay deduct a 5% discount of the tax due.
Any inheritance tax due will becoae delinquent
nine (9) aonths after the date of death.
PART
(!]
[CHECK ]
ONE
BLOCK
ONLY
r=J The above info...ation and tax due is corr ct.
1. You aay choose to reait payment to th 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 assessaent will be issued by the PA Department of Revenue.
B. c=l The above asset has been or will be repor ed and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's represent at ve.
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
(!l
C. ~The above information is incorrect and/or debts and deductions were paid by you.
You aust complete PART 0 and/or PART below.
PART
~
TAX RETURN - COMPUTATION
If you indicate a different
relationship to decedent:
OF
1
2
3
4
5
6
7
8
DEBTS
_ c.2:<S h
Computation)
.
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Under penalties of perjury, I declare that the
(~12~ &~nOWledge and belief.
acts I have reported
HOME c1t1
WORK c
TELEPHONE
above are true, correct and
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