HomeMy WebLinkAbout06-04-08COMMDNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE h
BUREAU OF INDIVIDUAL rAxes „-,~ F I L E ND . 21- ~~ ~ a(,• ~ ;2.
DEPT. 280601 r ~ ' ;YA~CPAYERNRESPONSE
HARRISBURG, PA 17128-0601 ACN 08123769
'"-'' '.;i- DATE 05-26-2008
REV-1543 EX-A~P~.~(~9-6SS ~ ~- -~~
~1tf~ ~~~ _~ Phi ~ : ~' TYPE OF ACCOUNT
ST. OF AMELIA M WILSON ~ SAVINGS
S.S. N0. 220-03-6649 ® CHECKING
.,„-
~.Ehrr' _ DATE OF DEATH 01-13-2008 ~ TRUST
D~P~~IS L~~~~ COUNTY CUMBERLAND ~ CERTIF.
CHARLES D WILSON
226 N 27TH ST
CAMP HILL PA 17011
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
SOVEREIGN BANK has provided the Department with the information listed below which has been 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 form and return it to the above address. Ttiis account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Cuestions may be answered by callbg~i7lTi 787-8327.
COMPLETE PART 1 BELDW * ~ * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1051068037 Date 09-26-1997 To insure proper credit to your account, two
Established C2) copies of this notice must accompany your
Account Balance 4,877 .70 payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Percent Taxable X 50 .000
Amount Subject to Tax 2,438 .85 NOTE: If tax payments are made within three
C3) months of the decedent's date of death,
TaX Rate X , 15 you may deduct a 5Y. discount of the tax due.
Potential Tax Due 365.83 Anv inheritance tax due will become delinquent
nine C9) months after the date of death.
PART TAXPAYER RESPONSE
A. ~ 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
CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of
0 N E
~ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K
0 N L Y 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 must complete PART ~ and/or PART ~ below. .
PART I f y o v i n d i c a t e a d i f f e re n t x r ate , l e a s e s tat a
P Your
~ ....... ....................................:... ...... ~,.:.:-::-::-::::::::::.:.::::.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.,.,.,.......::::
:~;:;:::::::::~s~::::s;:~:::::~.........,: ~ :.:.::.:.:.:::.: ~: ~~.::.:.:.:.:.:.::.:.::.:...........
2 relationship d1f~
to decedent: €:~::s:::::~::~::;:~:::s:t:[:::::_;:~~::ssr::;:::;:;~ :::::::::::::::::::::::.:~~:~ii~i:;i:?_='9[:i:9
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/TRy,ST ACCOUNTS
1_ ~`V -1, Z,a o 5
z N ~ 3't't . T 0
3 X ~~ ~ •
4 ~. 3 S . 9s 5
5 -.1~~SS. ~r
6 ~
8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
'~ t' ~ ~'~e'~ S
~`
~ o
~ ~ ~o : \~ d 6 $
~ a
do
- - ~ ax vvmpuiailOnJ $~- ~ ~~ ` $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. HOME C ~ ~ (~~~
~
~
~ ~. ~ WORK C Tl~ ~ ~
2 0 ~Ly'0 {
~'2 a'!r!
TAXPAYER SIGNATURE e
TELEPHONE NUMBER . ~
.
DATE