HomeMy WebLinkAbout08-17-09 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INOIV1DlML TAXES AND FILE N0. 21 08-0409
PG Box zeadol ;TAXPAYER RESPONSE ACN 09004262
WIRRISBURG PA 17128.0601 -
- __ DATE 06-12-2009
REY-1563 IX RFP (\\~Y\Z.'~,
TYPE OF ACCOUNT
2QG9 AUG { 7 /~M 9' 3~ST. OF EMMA K MEYER ^ 5AV[NGs
SSN 190-26-6982 ^ CHECKING
~LE}~K ~~ DATE OF DEATN 04-03-2008 ^ rRUSr
^r.nu n^f~~ h,~„n~ ROUNT AVMENT AND rFORMSL ATOD ^ CERTIF.
PATRICIA ROSS C.UM~rRLA ,~71r~,~ Pp, REGISTER OF WILLS
170 AMY DRIVE f, `I CUMBERLAND CO COURT HOUSE
CARLISLE PA 17013 CARLISLE, PA 17013
ROTH IRA provided the Depa rtaent with the into raation below, wh ieh has boon used in eelculatine 4ha
potential tax due. Records indicate that at the death of tho above -nee ed decedent, you were a joint owner/beneficiary of this account.
If you foal the intonation is incorraet, please obtain written correction froe the financial institution, attach a copy to 4his fo rn
end return it to the above add rasa. This account is taxable in aeeo rdanee with the In ha ritenca Tex laws pf the Coasonwaalth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No.
Account Balaneo
Pareont Taxahl•
Amount Suhloet to Tax
Tax Rato
Potential Tax Due
Data 03-03-2008
Established
To ensure proper credit to the account, bo
coplas of thls natite aYSt accpwpany
peysen4 tp 4ha Rapister of Wills. Make cheek
payable to "Repi star of Wills, A6ent".
$ 6,492.33
X zs.0oo
$ 1,623.08
X .15
PART
NOTE. If tax pavaents an aatle within three
aonths of the decedent's dots of death.
deduct a 5 percent discount pn tho tax duo.
Arai Inheritance Tax duo will beeaae delinquent
nine aonths of ter the dots of death.
A. ^ The above info nation end tax dus is correc4.
R\ait peyaan4 to 4ha Rapister of Wills with two copies of this notice tq obtain
r CHECK a discount or avoid interest, or cheek box '•A" and return this notice to the Reai star of
I ONE ~ Wills antl an official assessaent will be issued by 4ha PA Depa rtnent of Revenue.
L BLOCK B. Tha above asset has been or will ba reported and tax paid with 4ha Pennsylvania Inheritance Tax return
ONLY ~to be filed by the estate rep rosente4ive.
C. ^ The above inforaa ion is incorraet and/or debts end deductions were psitl.
Coaplet• PART 2~ and/or PART ~ below.
PART If intlieating a tlSfforont tax rata, please state
relatlonsh3p to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 S
3. Percent Taxable 3 X
4. Amount Subl act to Tax 4
5. Debts and Deduetlons 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Dua B
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
JJBRIE
V'r
Untlor ponalt ios of perjury. I doela re that th• facts I have report od above are true, correct antl
~,.~ ompleto to LM best of my knowL dg• and Delief. un\\v ,`7/7 ~ a'L~J~/ ~/