HomeMy WebLinkAbout07-09-08CDMMDNWEALTH DF PENNSYLVANIA I N F O RM A AND NOTICE F I L E N D. 2 1 ~~~ -""
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES ACN 08126249
DEPT. 288601 TAXPAYER RESPONSE DATE 06-06-2008
FUIRRISBURG, PA 17128-0601
REV-1543 E% AFP (09-09)
TYPE OF ACCOUNT
EST. OF GRACE M NASER ® SAVINGS
CHECKING
S.S. N0. 235-22-5167
DATE OF DEATH 03-29-2008 r,, ^ TRUST
COUNTY CUMBERLANI~Q ~ ^,cERTIF.
REMIT Plk~`M T AND ~MS T!~. _
REGISTER OF. ~ -~
JAMES E NASER CUMBERLAND RT ~iOUS~ ~ !-,~
APT 3323 CARLISLE, P%~F~'-)013tD _. :_~"
325 WESLEY DR `-~ ,--,
MECHANICSBURG PA 17055 `~ p ~~ -O `~::k"j
C ~
has provided the Department with the information listed below which has been us~in ,~? `'
PNC BANK
thisuaccountthIfpvounfeel thisdinfarmation isrincorrecttepleaseaobtaindwritten correctiondfromethe financialainstitution~,/attachcaacapYf
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. Questio.^.s may be answered by calling C7i7) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5002044026 Date 05-11-2000 To insure proper credit to your account, two
(2) copies of this notice must accompany your
Established payment to the Register of Wills. Make check
4 3 5.4 O payable to: "Register of Wills, Agent".
Account Balance
X 1 6 . 6 6 7 NOTE: If tax payments are made within three
Percent Taxable
Amount Subject to Tax 72 • 57 (3) months of the decedent's date of death,
• 0 0 you may deduct a 5Y. discount of the tax due.
Tax Rate X Any inheritance tax due will became delinquent
O 0 nine (9) months after the date of death.
Potential Tax Due
TAXPAYER RESPONSE
T
R
PA
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p, The above information and tax due is correct.
'y-~. 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.
B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
C ONE
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 2^ and/or PART 3^ below.
PART If you indicate a different tax rate, Please state your
relationship to decedent:
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/TRUST ACCOUNTS
1
2
3
4
5 -
6
7
8
PART
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION AMOUNT PAID
s
TOTAL CEnter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported aj vie ~r~e trule i cc/o~ ect and
complet o the best~°of my knowledge/and belief. HOME C ~7/ ~ (D t~r~
C ~ ~.ll / WORK C )
!nn fS ~ TELEPHONE NUMBER DATE