HomeMy WebLinkAbout11-10-08PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 08-0744
Po Box zaoe,ol TAXPAYER RESPONSE ACN 08149154
HARRISBURG PA 17128-0601
DATE 10-21-2008
REV-1543 EX AFP (OB-007
TYPE OF ACCOUNT
EST. OF LOIS M LANTZY ~ SAVINGS
SSN 161-34-2046 ~ CHECKING
DATE OF DEATH 07-03-2008 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0: ~,a
MARY K LANTZY REGISTER OF WILLS n m _
116 WINSTON DRIVE CUMBERLAND CO COURT H0 ..~,,: "
MECHANICSBURG PA 17055 CARLISLE, PA 17013 ~J--,-~ ~
_ .~~~7 ..~ : ~
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AMERICHOICE FCU provided the Department with the information below, which has been`:wSe~d in calcuhting the, `~
potential ta:K due. Records indicate that at the death of the above-named decedent, you were a joint owner/beQe#M ary of~is accoun~t'tl
If you feel the information is incorrect, please obtain written correction from the financial institution, ch a copy tA,this #orm"
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the CommonwearyQ~~~ of -
Pennsylvania. 'riease call i717) 787-6327 wiih questions. ---
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 2056-63 Date 01-22-2007 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance ~` 1 , 065.24 payable to "Register of Wills, Agent".
Percent Taxable X 100.00
NDTE: If tax payments are made within three
Amount Subject to Tax ~` 1,065.24 months of the decedent's date of death,
Tax Rate ~( 12 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 127.83 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO'RESPOND NtILLRESULT IN AN OFFICIAL TAX ASSESSMENT:.
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or 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.
C ONE
B L 0 C K B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above information is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. A<:count Balance
3. Percent Taxable
4. Arnount Subject to Tax
5. Debts and Deductions
6. Arnount Taxable
7. Tlax Rate
8. Tax Due
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF `REVENUE
1
2
3
4
5
6
7
8,
OF TAX ON JOINT/TRUST ACCOUNTS PAD
1
2
3 X
4
5
6 '~
7 X
8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PA][D PAYEE DESCRIPTION AMOUNT PAID
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 7~7 ) 71.~C~ - ~07(~
`y'~ ._) aLJtc~.-, ~• O~CL~t-~ N- W O R K ( ) / 1- ~ 7 - O ~'i 1
~..... ...~.. .. ...,. r,m r TCI CDLJ 1'1 AIC AIIIMIICD T1ATC L/~nl
TOTAL (Enter on Line 5 of Tax Computation) S