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HomeMy WebLinkAbout06-20-07 COMMONWEAL TH OF PENNSYLVANIA -.. OEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES r,'- r.' .r.r~ ., C.D O~ . . . - DEPT. 2B0601 I~t''.i\ Ill!)'... J HARRISBURG, PA 17128-0601 r'cr"lc'rr~ n': , .. t~L\J,j1,J" 'vI ,Vi.,-- REY-1543 EX AFP (09.00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0448 07001622 06-07-2007 CLERK OF QRP1-LA.N'S COURT CUMBERLN-.t[) CO.. PA EST. OF MARY C MARCONI S.S. NO. 177-24-1385 DATE OF DEATH 04-20-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS D CHECKING D TRUST !Xl CERTIF. 2001 JON 20 PH 2: '5 ** ROBERT MARCONI 218 N ARCH ST MECHANICSBURG PA 17055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HEHBERS 1ST FCU has provided the Depart..nt with the information lishd below which has bun 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 information is incorrect, please obtain written correction from 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 Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8127. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 260553-41 Date Established 03-22-2007 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to. "Regishr of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x 7,038.89 100.00 7,038.89 .045 316.75 TAXPAYER RESPONSE NOTE. If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5X discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. x PART ill [CHECK ] ONE BLOCK ONLY A. c=l The above information and tax due is correct. 1. You may choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. 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 information is incorrect and/or debts and deductions were paid by you. You aust coaplete PART ~ and/or PART ~ below. PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state YOUI' relationship to decedent: PART ~ TAX RETURN - COMPUTATION 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 OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) . . declare that the facts belief. have reported above are true, correct and 3~~-'fU~o8 ( 7/ 7 ) WORK ( ) TELEPHONE NUMBER IJ:, - 2LJ -rt> "7 DATE HOME T