HomeMy WebLinkAbout01-20-09PENNSYLVANIA INHERITANCE 'TAX
INFORMATION NOTICE
AND FILE N0. 21 ~v9' ~~~~
BUREAU OF INDIVIDUAL TAXES ^-t~ - --
Po Box zaocol = 'TAXPAYER RESPONSE ACN 09101519
HARRISBURG PA 17128-0601 _ -- ~ DATE 01 - 15 - 20 0 9
-~,
REV-1543 EX AFP (OB-08)
,,,~
NANCY GROSS
347 JUNIPER DR
ETTERS
PA 17319-9408
EST. OF ALBRIGHT GROSS
SSN 174-c'0-9805
DATE OF DEATH o7'-04-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17(113
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
BANK OF AMERICA NA provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint: owner/beneficiary of this account.
If you feel the 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
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELGW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 68100401313006 Date 11-21-2004 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 $ 89, 021 • 20 payable to "'Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject t:o Tax $ 44, 510.60 months of the decedent's date of death,
Tax Rate X , 15 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential TaX Due $ 6, 676.59 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT 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
a discount or avoid interest, or check box "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
B L 0 C K 1S. ~ 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.
(:. ~ The above informs ian is incorrect and/or debts and deductions were paid.
Comvlete PART 2~ and/or PART ~ below.
PART If indicating a different
relationship to decedent: tax rat~
.~ CC`` rpl~~ state
JJU OFFICIAL U5E ONLY ~ AAF
PA DEPARTMENT OF REVENUE
TAX
LINE RE
1. TURN - COMPUTATION OF
Date Established 1 TAX ON JO~~77INT/TRyU~ST
~lI ~C7ll ~ ~ r/ ACCOUNTS PAD
1
2. Account Balance 2 $ Q ~ ~ ~ 2
3.
4. Percent Taxable 3
Amount Subject to Tax 4 X
$ J
~~~
~ 3
4
5.
6. Debts and Deductions 5
Amount Taxable 6 -
'~ `~~
a ~ ~~
~ 5
6
7. Tax Rate 7 X ~~lJ 7
8. Tax Due B $ 4 ~ ~~ 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported ^-a7bove eire(x~f e, corre7c-~t and
compl~tle~r~to~~th~e best of~'y lodge and belief. HOME C/~~ ) J~~"' [i ~ ~.
IX PAYER SIGNA'URE TELEPHONE NIUMBER DA E [ }
TOTAL CEnter on L1ne 5 or iax compucau oni a