HomeMy WebLinkAbout03-17-08
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URI~, PA 17128- 0601
..
FILE
ACN
DATE
NO. 21'~~- (j,;297
08106150
02-12-2008
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV-15li3 EX AFP (09-00)
L~~.J H:"IK ! 7 PH l~>:
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TYPE OF ACCOUNT
D SAVINGS
[Xl CHECKING
D TRUST
D CERTIF.
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EST. OF VELMA B NYE
S.S. NO. 204-30-7140
DATE OF DEATH 11-21-2007
COUNTY CUMBERLAND
LARRY R NYE
403 BENYOU LANE
NEW CUMBERLAND PA 17070
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FUL TON BANK has provided the Department with the information listed below which has been used in
calculatin:g the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this accoulnt. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PennsYlvania. \lues.1ons may De answered bY calling CIll} '/61-832'1.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accclunt No. 3619-67159
Date 10-15-1997
Established
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: "Register of Wills, Agent".
Accclunt Balance
Percent Taxable
Amount Subject to Tax
Tax Rat'
Potential Tax Due
PART
ill
4,786.27
X 50.000
2,393.14
X .15
358.97
TAXPAYER RESPONSE
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
A. r=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.
[CHECK ]
ONE
BLOCK
ONLY
B. r=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.~e above information is incorrect and/or debts and deductions were paid by you.
. You must complete PART ~ and/or 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 ta~rate, please state your
relat ionship to decedent: /) 11
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!l
DATE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
e
AMOUNT PAID
facts
have reported above are true, correct and
( 1/ 7 ) C!:a ~ -{ cJ tv
WORK ( )
TELEPHONE NUMBER
HOME
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ATE 'r (
cJI-)OOt. 6:297
ESTATE OF VELMA B NYE
S.S. NO 204-30-7140
DATE DUE PAYEE DESCRIPTION AMOUNT PD
1/16/2008 Parkville Cemetery Grave Digging $200.00
2/18/08 Quantum Imaging & Expense at Holy Spirit $6.46
Therapeutic Assoc.
2/18/2008 CCS-Consolidated Collection West Shore Emergency Med $60.02
Service Inc
2/19/2008 West Shore EMS-BLS Emergency Transfer, Oxygen $165.93
& Mileage
Baughman Memorials Engraving Tombstone with $200.00
Date of Death
(We contracted with Baughman and they will be doing the engraving some time
During the Spring.)
Total on this page $632.41
Total from previous page 3,092.01
Total Expenses from death 3,724.42
Account Balance on 11/21/07 4,786.26
Balance at this point $1,061.84
It is possible there will be more bills forthcoming......... .but this is where we stand at this
point. . .3/12/2008.
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