HomeMy WebLinkAbout02-03-09PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
BUREAU OF INDIVIDUAL TAXES TAXPAYER R E S P O N S E
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543 E% AFP (08-OB)
FILE N0. 21 OS-1291
ACN 09105379
DATE 01-27-2009
EST. OF DOROTHY R GUISE
SSN
DATE OF DEATH 12-21-2008
COUNTY CUMBERLAND
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
Q CERTIF.
r.~
0
REMIT PAYMENT AND FORMS T0: ~ p '-;
.t~ <,
REGISTER OF WILLS ~~ '*'t s
** ROGER W GUISE CUMBERLAND CO COURT HOU-q ~ ~ f',
'
925 CLY ROAD PA 1
YORK HAVEN 7370 CARLISLE, PA 17013 ~ I'-- -
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, .
~ calculaL4~g the°~
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y
provided the Department with the information below, which has been us
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MEMBERS 1ST FCU
potential tax due. Records indicate that form
to ~is
opv
a
att
at the obtain written correction fromethe financial institutions
Commonwealth o
f th
If you feel the information is incorrect,
e
pleas
unt is tau able in accordance with the Inheritance Tax laws o
and return it to the above address. This
Pennsylvania. Please call (717) 787-8327 acco
with questions.
E FOR FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW * SEE REVERSE SID
Date 11-28-2008 To ensure prover credit to the account, two
Account No. 7658-43 copies of this notice must accompany
ke check
M
a
Established payment to the Register of Wills.
57, 134 .26 payable to "Register of Wills, Agent".
Account Balance $
.. 100.00
'- OTE: If tax payments are made within three
Percent Taxable months. of the decedent's date of dea ,
- - 5'7,34.26
Amount Subject to TaX _
~
045 deduct a 5 percent discount on the tax due.
will become delinquent
d
TaX Rate .
ue
Any Inheritance Tax
X
2, 571 • 04 nine months after the date of death.
Potential Tax Due $
TAXPAYER RESPONSE
p~T
~
RESPOND WILL RESULT IN AN OFFICIAL TAX A55ESSMENT
FAILURE TO
A.
CHECK
ONE
[ BLOCK B
ONLY
C
^ The above information and tau 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
Wills and an official assessment will be issued by the PA Department of Revenue.
~' The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
ONLY ~ AAF
PART If indicating a different tax rate, please state
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
o Tom., nil P_
PART
DATE PAID PAYEE
PAD
1
2
3
4
5
6
7
8
OFFICIAL USE
PA DEPARTMENT OF REVENUE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
s
TOTAL CEnter on Line 5 of Tax Computation)
nder penalties of perjury, I declare that the facts I have reported ab/ov'~e are truel,~ c~o~rr2ect and
/~omplete to the est of my knowledge and belief. HOME ~7/! ~~~^'-""~
,//J ~~~ WORK C ~
J/ ,inae l / TGi FPHONE NUMBER DATE
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 s 57 / 3 ~ ~1C
3 x 5'°, oa
5
`
6 $ ~fl ~/ 7 1
~ _
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