HomeMy WebLinkAbout07-20-09 (3)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 09-0352
BUREAU OF INDIVIDUAL TAXES ACN 09138567
PD Box 288601 TAXPAYER RESPONSE
HARRISBURG PA 17128-0681 DATE 06-22-2009
REV-1543 EX I1FP (OB-OB)
EST. OF RODNEY J SMITH
SSN 172-40-8130
DATE OF DEATH 03-28-2009
TYPE OF ACCOUNT
® SAVINGS
^ CHECKING
^ TRUST
COUNTY CUMBERLAND ~ ~ ^ CERTIF.
REMIT PAYMENT AND FORMS T0: C 0 w __
** JAMES K SMITH REGISTER OF WILLS ~7-~p C r
CUMBERLAND CO COURT HOU$~L:C7 r--
900 DIETZ RD
YORK PA 17402 CARLISLE, PA 17013 -~ ~ iv ''-
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SOVEREIGN BANK "~ ,
provided the Department with the information below, which has been bd in calcul~ng the
ou were a joint owner/beneficiary of account.
t
d
en
, Y
potential tax due. Records indicate that at the death of the above-named dece
ction from the financial institution, attach a copy to his form
If you feel the information is incorrect, please obtain written corre
t is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
and return it to the above address. Thi s accoun
Pennsylvania. Pleasa eal'_ L7171 787-8327 with gce~ticr.s.
SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW *
Account No. 0784021438 Date 03-16-2009 To ensure prover credit to the account, two
copies of this notice must accompany
Established
payment to the Register of Wills. Make check
ce
l
B $ • ~ 0 payable to "Register of Wills, Agent".
an
a
Account
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Tax
t t ~` • ~~ months of the decedent's date of death,
o
Amount Subjec deduct a 5 percent discount on the tax due.
Tax Rate ~( .045 Anv Inheritance Tax due will become delinquent
` • ~~ nine months after the date of death.
Potential TaX Due $
TAXPAYER RESPONSE
PART
FAIkURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX A55ESSMENT
A. The above information and tax due is correct.
f this notice to obtain
i
Remit payment to the Register of Wills with two
"
" es o
cop
notice to the Register of
thi
a
A
discount or avoid interest, or check box s
nd return
C H E C K a
Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
b
or will be reported and tax
paid with the Pennsylvania Inheritance Tax return
B L 0 C K B. ^ The above een
asset has
0 N L Y to be filed by the estate representative.
^ The
C above informs ion is incorrect and/or debts and deductions were paid.
.
Com plete 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
1
2
3 X
4
5
6 `~
7 X
8 +~
PAD
OFF iCiAL UJt UfVL T u AA(
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
PART
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) ~
Under penalties of perjury, I declare that the facts I have reported a/b~ove are ~ ;e, co~r ~c1~t~nd
com lete to the best of my knowledge and belief. HOME C 1~~ ~ 'T ~ ' -7
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/° (Ji' ~~~~~~ " ~~ ~ TFI FPHONF NUMBER DATE