HomeMy WebLinkAbout03-09-09 (3)PENNSYLVANIA INHERITANCE TAX
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MEMBERS 1ST FCU provided the Department with the information below, which has been used-i;l~eel.cula_~'t1g the_;~-: ~\
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/benef5r~,ary-of tki~ accou)rt~ t
If you feel the information is incorrect, please obtain written correction fro^ the financial institution, attas,h $:c~ly to Phis farm
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the.Gn~i~wealtlaCaf
Pennsylvania. Plaasc call C717) ?E?-B32? with gsestions. ~~ ;-, -~ 4.._z
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU`C_~`F®NS -~,
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Account No. 250943-1 1 Date 09-13-2004 To ensure Proper credi~fSithe accoypi, twq.:- ,
Established copies of this notice-hirLSt accompa ~i - -
5, 512.15 Payment to the Register of Wills. ~ke check
Account Balance $ payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 918.71 months of the decedent's date of death,
Tax Rate X , 00 deduct a 5 percent discount on the tax due.
. 0 0 Any Inheritance Tax due will become delinquent
Potential Tax Due $ nine months after the date of death.
PART TAXPAYER RESPONSE
1
FAILURE TD RESPOND WILL RE-SUET 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.
INFORMATION NOTICE !,
BUREAU OF INDIVIDUAL TAXES AND FILE ND. 21 VC'' ~ZZ1
Po Box 280601 TAXPAYER RESPONSE ACN 09108140
HARRISBURG PA 17128-0601
DATE 02-12-2009
REV-1543 EX I1FP (OB-087
TYPE OF ACCOUNT
EST. OF L C FURRY ~ SAVINGS
S$N 205-30-6310 ® CHECKING
DATE OF DEATH 01-21-2009 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
LEONA FURRY REGISTER OF WILLS
1925 CHATHAM DRIVE CUMBERLAND CO COURT HOUSE
CAMP HILL PA 17011 CARLISLE, PA 17013
C ONE
BLOCK 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 informs ion 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. 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
2
3 X
4 +fi
5 -
6
7 X
8
PAD
OFFICIAL U5E DNLY ~ AAF
PA DEPARTMENT DF REVENUE
1
2
3
4
5
6
7
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
c~ovmplete to the best of my knowledge and belief. HOME C -717 ) 7L3"'fD`l~
oS .C.cr'u~z. ~~ ch n1~ WORK C ) j~~,p~ >
TAYDAVCD CTCIJA TIIDC rr, rounur u„unrn. r.•rr (~
TOTAL CEnter on Line 5 of Tax Computation) 8