HomeMy WebLinkAbout06-16-08COMMONWEALTf1 OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
i_REV.isks, EfC;,wP,; los-ae>>.
INFORMA AND NOTICE
TAXPAYER RESPONSE
2~~~~8 J~J~~~ i ~ P~ 2~ !
C' Ltli\ lei"
Q~{~I-~~~~~` ~ ~L~~~
GORDON GRAVES
308 GLENN AVE
BOILING SPRGS PA 17007
FILE N0. 21 QQj'~`I~~
ACN 08104180
DATE 02-04-2008
TYPE OF ACCOUNT
EST. OF FREDERICK GRAVES ^ saviNGs
S.S. N0. ® CHECKING
DATE OF DEATH 11-24-2007 ^ rRUST
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MEMBERS 1ST FCU 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 Soint 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 Taz Laws of the Commonwealth
of Pennsyivania. questions may be answered by calling 1717) 7S7-S3Z:.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 67885-11 Date 05-03 -2000 To insure proper credit to your account, two
Established (2) copies of this notice must accompany your
payment to the Register of Wills. Make check
Account Balance 6,266. 20 payable to: "Register of Wills, Agent".
Percent Taxable X 8. 333
NOTE: If tax payments are made within three
Amount Subject t0 T2X 522. 16 C3> months of the decedent's date of death,
Tax Rate X . 045 You way deduct a 5Y. discount of the tax due.
Any inheritance tax due will .become delinquent
Potential Tax Due 23. 50 nine (9) months after the date of death.
::. .. ~~: ~: ~ ~::;: :.: ; ::: ::-;AH, ..:tl~:F.~~:tAE.....~`~...~.E~: N~~Ifi ~~ ~I~:~#!H€;:~:~ IS- fiI~~E
;: - ;.: ~UE€'CD::;;:N~1?!D~l~...1l1;~IrI,.....~~~ F't; :::~N; ..:........:......................................
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
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
CHECK Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
B L 0 C K
C 6. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY t e filed by the decedent's representative.
C. The above information is incorrect an r deb nd deductions were paid by you.
You must complete PART 2^ and/or P T 3^ be w.
PART If you indicate a different tax rate, please state your
a relationship to decedent:
TAX RETURN - COMPUTATIDN
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
G;. Amount Taxable
i'. Tax Rate
t3. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 G ', C. ~i ' ,~ ~
3 x f. 333
4 .~ ~-~- .
6 ~-` O -.
7 X ~'-A'1
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
.;
TOTAL (Enter on Line 5 of Tax Computation) S
Under penalties of perjury, I declare that the facts I have reported atrovref ra-r~e true, correct and
c:om etc t t e st of my knowledge and belief. HOME C~2~7 ) .~~ o ~~~jd
WORK ( ) ~~~2eU
TELEPHONE NUMBER DATE