HomeMy WebLinkAbout04-06-09INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES ~~ ~-,~~~ t'1+~ AND FILE N0. 21 -'Q9-(~~7
PD BOX 280601 +r `~~ ~4 ~ ~'fA~AYER RESPONSE ACN 09107741
HARRISBURG PA 1 7128-0601 (;Mtn r, 1~~{ Vi y ti ~ , ~. DATE 02-10'2009
REV-1541 IX APP Cd6-Od~J
PENNSYLVANIA INHERITANCE TAX
20D9 APR -6 PM 12~ 5~
~~~
CUMBF~I.~'d~1D CO.. ~!
ANGELA JOHNSON
17 LARCH DR
SHIPPENSBURG PA 17257
EST. OF EMORY G JOHNSON
SSN 210-18-9583
DATE OF DEATH 11-17-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
ADAMS COUNTY NATIONAL BANK 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 ioint owner/beneficiary of this account.
If you feel the information is incorrect, Dlease 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
Penn ry'A vania. Ploase call C?17) 78?-8?2? with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 9651446 Date 10 -17 - 1986 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 $ 380.66 payable to "Register of Wills, Agent".
Percent Taxable X 100.00
NDTE: If tax payments are made within three
Amount Subject to Tax $ 380 • 66 months of the decedent's date of death,
R
t X 045 deduct a 5 percent discount on the tax due.
a
e
Tax . Any Inheritance Tax due will become delinquent
Potential Tax Due $ 17 • 13 nine months after the date of death.
PART TAXPAYER RESPONSE
0
u
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
1
2
3 X
4
5
6
7 X
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perju y. I declare that the facts I have reported abov are ru c r~ a d '1
pmp etc o t gybes y k owledge and belief. HOME C ~ )
~ r ~ ~ ~L'~. WORK ( )
TAXPAYE I NA URE~ TELEPHONE NUMBER T
TOTAL CEnter on Line 5 of Tax Computation) s