HomeMy WebLinkAbout03-09-09 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 p~1C)2Z~
PD Box zao6ol TAXPAYER RESPONSE ACN 09108139
HARRISBURG PA 17128-0681
DATE 02-12-2009
REV-1543 EX AFP (OB-OB)
TYPE OF ACCOUNT
EST. OF L C FURRY ® SAVINGS
SSN 205-30-6310 ~ CHECKING
DATE OF DEATH 01-21-2009 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
LEWIS C FURRY REGISTER OF WILLS C'7
110 WATSON LANE CUMBERLAND CO COURT HOU~p `~"' _ -_
NEW BLOOMFIELD PA 17068 CARLISLE, PA 17013 -: x) ;:~; , :-
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MEMBERS 1ST FCU provided the Department with the information below, which has been Usad, in celcula~~ng the.-~- "'?
Dotential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/benefary of accpuRtC
If you feel the information is incorrect, please obtain written correction from the financial institution, at~akh a copy to• his farm ' '
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of tfie Commonwealt~jof
Pennsylvania. Please call (717) 787-8327 with questions. ._., Y ~--
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 250943-0 0 Date 09-13-2004 To ensure proper credit to the account, two
Established copies of this notice must accompany
8 9 9 .4 7 payment to the Register of Wills. Make check
Account Balance $ 1, payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to TaX $ 316.58 months of the decedent's date of death,
TaX Rate X .045 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due $` 14.25 nine months after the date of death.
PART TAXPAYER RESPONSE
~ FA1Llt"~.'E 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
C H E C K 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.
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 IJ below.
PART If indicating a different tax rate, please state OFFICIAL U5E ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Establ3si)ed 1 j
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID 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 (-7 t"1 ) ~1-~-/l/7 1
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TOTAL (Enter on Line 5 of Tax Computation) 6