HomeMy WebLinkAbout06-16-08CO NWEALTH OF PENNSYLVANIA
DF ,~trMENT OF REVENUE
w vu U OF INDIVIDUAL rAxes
DEPT. 280601
HARRISBURG, PA nI2B-o6al
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REV-1543 IX I1FP (09-U10.
INFORMATION NOTICE
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FILE
ACN
DATE
N0. 21'~~-U~Os~
0$127125
06-06-2008
TYPE OF ACCOUNT
208 JU~~ 16 P~~: ~' EMILY K LAWLER ^ SAVINGS
$.$. N0. 187-16-2750 ® CHECKING
~~ ~t~K ~~ATE OF DEATH 03-28-2008 ^ TRUST
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RP;-~~'~d";~; v~Jr.WY~TY CUMBERLAND ^ CERTIF.
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REMIT PAYMEN T AND FORMS T0:
MARY J GRIGG REGISTER OF WI LLS
1400 CONCORD RD CUMBERLAND CO COURT HOUSE
MECHANICSBURG PA 17050 CARLISLE, PA 17013
PNC 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 point 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. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvanie. Questions may be answered by calling C717) 787-B327.
COMPLETE PART 1 BELOW * * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140238208 Date 05-01-1979
Established
Account Balance
5,283.12
To insure proper credit to your account, two
C2) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable ta: "Register of Wills, Agent".
Percent Taxable X 50.000
2, 641.56 NOTE: If tax payments are made within three
Amount Subject to Tax (3) months of the decedent's date of death,
TaX Rate X , lj you may deduct a 5Y. discount of the tax due.
3 9 6.2 3 Any inheritance tax due will become delinquent
Potential Tax Due nine (9) months after the date of death.
PART TAXPAYER RESPONSE
1 :~::~ ::::::::::::::::::: ~:.:::::::::::::::::::::~:::~:~:~:~::::::.:.:..................._..........................................................................
:::::::::::::::::::::~::::::::::::::::::::::-~:::~:::::::::.............................................................................._:::t~l:::tai.....~1.~.~:~A~::.....~AI~:,:AS~:E :::~:::::~ :::::: ::::..::::;:;
........................................::..._:....::::::::,,.:....................................,..............................................._:::::::::::::.............,......................................:............,...................._:~,~~l;Efi::::~A~:E3#::::D~1.....'f#I.I.'~.....#Illfi :.:.
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.
BLOCK ~ B. ^ The above asset has been or will be revorted and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y 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.
I f yo v i n d i c a t e a d i f f e r :::::::~ :::::::::::: .:::~::::::::::::::~::::::::::::;:::; :::;:::;::::~':::::::::;:::~::.:::: ~:~ ~:;:::::::.,:,:,.,.,.....,.... ..::::-::::::::,::.,
PART ent tax rate, please state your .:.:. :.::::::: :::: :•::,.~:::;.;,..,.:.::
relat :::::::::::.:..:::::::::::::::::::
ionshi to ::::::::::~ :::::::::::::::::::::::
P decedent : ...................................................:..........................._......'................_~?~::: i:::::ii: ~:~E~:
TAX RETURN - COMPUTATION
LINE i. 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
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PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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TOTAL (Enter n Line 5 of Tax Comp ation) 8
Under penalties of perjury, I declare that the facts I have reported above are true, cor ect and
complete to the best of knowledge and belief. HOME C `?~ Y] ) ~ ~ ~ - ~ R `JZ
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