HomeMy WebLinkAbout10-17-07
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 61 c:AG5
07140001
10-09-2007
REY.lS43 EX AFP (09-00)
EST. OF GEORGE D GULDEN
S.S. NO. 174-20-0793
DATE OF DEATH 07-25-2007
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
Iil CHECKING
o TRUST
o CERTIF.
JOAN MCBRIDE
109 W BUTLER ST
MT HOLLY SPGS PA 17065
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COU~To HOUSE
CARLISLE,(~A 170I~~
,....~_ --J
o
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--:
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PNC BANK has provided the Department with the information listed below which ties' been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent. you were aJ.rnt ow~beneficiarY. of
this account. If you feel this information is incorrect, please obtain written correction from the financial'~stituti~Lattach a coPY
to this form and return it to the above address. This account is taxable in accordance with the Inheritance ~~ Laws of the commonwealth
of Pennsylvania. Questions .."y be "ns",,,rQd by calling (717) 787-8327. ...~ <:::, 1...0
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU~IONS
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I
Account No. 5140185302
Date 04-01-1963
Established
To insure proper credit to your account, two
{2l copies of this notice must accompany your
payment 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
11,618.63
X 16.667
1,936.48
X .15
290.47
TAXPAYER RESPONSE
NOTE. If tax payments are made within three
{3l months of the decedent's date of death.
you may deduct a S% discount of the tax due.
Any inheritance tax due will become delinquent
nine {9l months after the date of death.
PART
[!1
A. c=J The above information and tax due is correct.
1. You may choose to remit payment 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. c=J 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. ~he above information is incorrect and/or debts and deductions were paid by you.
,. . You must complete PART ~ and/or PART ~ below.
[CHECK ]
ONE
BLOCK
ONLY
x
, Olf.5
-0-
PART
[!I
TAX
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
I!I
RETURN _ COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
X
/. q~.tI~
_~:~3g/D
I
DEBTS AND DEDUCTIONS CLAIMED
M
PAYEE
DESCR I PTI ON
AMOUNT PAID
'6
'l.iL
TOTAL (Enter on Line 5 of Tax Computation)
$
Under penalties
~~:e best
perjury. I declare that the facts I
kno~ledge and belief.
k
have reported above are true. correct and
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