HomeMy WebLinkAbout08-22-07 (3)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG. PA 1712B-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 07-0449
07132242
07-26-2007
REV-lS43 EX AFP (09-00>
TYPE OF
ACCOUNT
o SAVINGS
IX] CHECKING
o TRUST
D~ERTIF .
EST. OF ANNA LEONARD
S.S. NO. 019-12-2361
DATE OF DEATH 04-11-2007 ~~
COUNTY CUMBERLAN~ E3
C;o ........
REMIT PAYi11;lST AND ~MS iii~, ,-
REGISTER OF ~ G?
CUMBERLANDC~RT rl:tDUSIi
CARLISLE, PA;;1:J:D13N '.,\
~-' -' /",
JUNE L KOONS
10 GLENDALE DR
MECHANICSBURG PA 17055
() ~
-'n ~
=0
TI -,-1
J;~ W
PNC BANK has provided the Depart.ent with the infor.ation listed below which' has been use~
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 for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth
of Pennsylvania. Questions .ay be answered by call;nq (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
N
Account No. 5140037609
Date 12-22-2000
Established
To insure proper credit to your account, two
(2) copies of this notice .ust acco.pany your
pay.ent 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
ill
10,433.18
X 50.000
5,216.59
X .045
234.75
TAXPAYER RESPONSE
NOTE: If tax pay.ents are .ade within three
(3) .onths of the decedent's date of death,
you .ay deduct a 5% discount of the tax due.
Any inheritance tax due will beco.e delinquent
nine (9) .onths after the date of death.
A. c=J 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 .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. c=J The above infor.ation is incorrect and/or debts and deductions were paid by you.
You .ust complete PART 0 and/or PART ~ below.
OF TAX ON JOINT/TRUST ACCOUNTS
I
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)
.
perjury, I declare that the facts have reported above are true, correct and
my knowledge and belief. I
HOME ( ) c)
WORK 01] ) ") J /) - '/J) U r/;~/)
T~I ~p~nN~ NIIMR~R DAT