HomeMy WebLinkAbout06-04-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 01 () '5'-\~
07123180
05-31-2007
REV-1543 EX AFP eQ9-oO)
EST. OF BERTHA E LAY
S.S. NO. 204-01-7572
DATE OF DEATH 04-25-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[i] SAVINGS
o CHECKING
o TRUST
o CERTIF.
PATRICIA B HENRY
26 CAMBRIDGE CT
CARLISLE PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU has p..ovided the Depa..bent with the info...ation listed below which has been used in
calculating the potential tax due. Thei.. ..eco..ds indicate that at the death of the above decedent. you we..e a joint owne../beneficiar-y of
this account. If you feel this info..aation is inco....ect. please obtain w..itten co....ection f..oa the financial institution. attach a copy
to this fo..a and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax Laws of the Coaaonwealth
of Pennsylvania. Questions may be answe..ed by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 197620-00
Date
Established
10-10-2000
. .....;~l
To insu..e p..ope.. cr,e(it to you.. account, two
(2) copies of this~t)J\e aust a~apany you..
payment to the Regi~f Wills,--Make check
payable to: "Register" ~ ~lls, 4ll:!!nt".
,._L~
NOTE: If tax payaent~~ade w~thin th..ee
(3) months of the deC8~~~s dat~uf death,
you aay deduct a 5X di$eoUn~ of the tax due.
Any inhe..itance tax ~ue~~ bec~ delinquent
nine (9) Months afte.. ~"d~te 0(:4eath.
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
2,164.94
50.000
1,082.47
.045
48.71
TAXPAYER RESPONSE
x
PART
[!]
The above info..aation and tax due is co....ect.
1. You aay choose to ..e.it pay.ent to the Registe.. of Wills with two copies of this notice to obtain
a discount 0.. avoid inte..est, 0.. you may check box "A" and ..etu..n this notice to the Registe.. of
Wills and an official assess.ent will be issued by the PA Depa..tment of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. r=J The ebove asset has been 0.. will be ..epo..ted and tax paid with the Pennsylvania Inhe..itance Tax ..etu..n
to be filed by the decedent's ..ep..esentative.
c. r=J The above info...ation is inco....ect andlo.. debts and deductions we..e paid by you.
You aust co.plete PART ~ andlo.. PART ~ below.
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
PART
~
TAX RETURN - COMPUTATION
If you indicate a different tax rate, please state your
relationship to decedent:
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)
.
have reported above are true, correct and
( ~ ( 1 ) :J.~!p - 0 <f 6S-
( )
Under penalties of perjury, I declare that the facts I
complete to the best of my knowledge and belief.
~!~~-~.~._~
HOME
WORK
(P L!SJ j. t)() 7 <{
TCICDun...c ...IIMRCD