HomeMy WebLinkAbout03-10-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE ('~'ba
BUREAU OF INDIVIDUAL TAXES ~~ AND FILE N0. 21_ ~ 3~
DEPT. 280601 "^ ~~ ACN 08139134
HARRISBURG, PA 17126-0601 ~ -'.. TAXPAYER R E S P O N S E
~~~',. DATE 08-28-2008
r'{tr_ ~ t -v~4 (~EYLI$43 E% I1FP ~(09-99)
?Q~9 MAR t 0 AM 10~ 45
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CHARLES K JONES
APT 106
300 RAMSEY PLACE
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
EST. OF EVELYN L JONES ^ SAVINGS
S.S. N0. 201-18-3094 ® CHECKING
DATE OF DEATH 06-12-2008 ^ TRUSr
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FULTON BANK has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a point owner/beneficiary of
this account. If you feel this 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
a. r~r~sylar:a. ^vues:;c.u aay be ars.~red by ca~~in& 1717: ', o7-o3Z7.
COMPLETE PART 1 BELOW * * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0 0 04-3856 1 Date 12-27-2001 To insure proper credit to your account, two
Established (2) copies of this notice must accompany your
Account Balance 3, 441.55 payment to the Register of Wills. Make check
payable to:. "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax 573.60 NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
Tax Rate X , QO you may deduct a 5% discount of the tax due.
. 0 0 Anv inheritance tax due will become delinquent
Potential Tax Due nine C9) months after the date of death.
P~T TAXPAYER RESPONSE
1 ,.
E T L LT A TAX S ANT H-
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, ar you may check box "A" and return this notice to the Register of
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ^ The above asset has been or will be reported and tax void with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the decedent's representative.
C. ^ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART 2^ and/or PART 3^ below.
PART If you indicate a different tax rate, please state your ~:
relationship to decedent:
P
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS q~ --
LINE 1. Date Established 1 y, 1 ' °"
2. Account Balance 2 2 ,~.,~
3. Percent Taxable 3 X ~ ~
p<
,;
4. Amount Subject to Tax 4 4
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 b
7. Tax Rate 7 X 7
8. Tax Due 8
PART DEBTS AND DEDUCTIONS CLAIMED ,
0
DATE PAID PAYEE DESCRIPTION eMniiNr porn
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.
~.lflGvuk- ~~~~--. HOME ( r'1 ) '1H S1 36
/~ ~J,a WORK C ) `j ~ V 9
TAXPAYER IGNAT E T TELEPHONE NUMBER DATE
ivis~~ ienier on Line 5 of Tax Computation) $
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601 _ •.-
i-,.~-.
REY-li5~t'_F~rf'05p IY91
INFORMATION NOTICE FILE N0. 21`~0~ (~,
-;-~ "~ --~' AND ACN 08139135
-TAXPAYER RESPONSE
DATE 08-28-2008
TYPE OF ACCOUNT
ZOa9 BAR , ~ ~~ ~~~ ~5EST. OF EVELYN L. JONES ~ SAVINGS
S.S. N0. 201-18-3094 ® CHECKING
C~~~;~ ~.~ DATE OF DEATH 06-12-2008 TRUST
' ~J~
(~R~~-{~~~` J `i~~,{RT COUNTY CUMBERLAND ~ CERTIF.
~~~'~'- - --~ ~'~- '-• - ~ REMIT PAYMENT AND FORMS T0:
CORAL SHAMBAUGH REGISTER OF WILLS
1736 MAIN ST CUMBERLAND CO COURT HOUSE
MECHANICSBURG PA 17055 CARLISLE, PA 17013
FULTON BANK has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this 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
uP FennSyi~auia. ~uesii~:ii~ way Le a..>»~: ~.. w ..a~~...a .:I7i .... ...,~..
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
.,,.~
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 decedent's representative.
C. ® The above information is incorrect and/or debts and deductions were paid by you.
You oust complete PART 2^ and/or PART 3^ below.
PART If you indicate a different tax rate, please state your
relationship to decedent: _~=~1 l' ~=
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
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
1
~ 2
3 X ~(O.(OL~
4
5
6
7 X
8
r ,~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above/are true, `correct and
complete/n~to the best of my// knowledge and belief. HOME C '7 ) ~ 9 ~ U! .~~
~~ ~,~ ~~"~~'f!~ WORK C ) 3 ~ ~ d
TAXPAYER I'GNATURE TELEPHONE NUMBER DATE
IUTAL ctnter on Line 5 of lax Computation) #