HomeMy WebLinkAbout08-17-09 (5)PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
BUREAU OF INOIVIOUAL TAXES AND
PD 9Dx zeasol - ~~ TAXPAYER RESPONSE
IWRRIS 9UR6 PA 17129-0601 -- - -
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FILE N0. 21 08-0409
ACN 09004267
DATE 06-12-2009
2004 AUG 17 AM 9~ $4 EST. OF EMMA K MEYER
SSN 190-26-6982
CLERK OF DATE OF DEATH 04-03-2008
'ORPHAN`S COURT COUNTY CUMBERLAND
CVIV'sFRI h,",~!~ !'Q PA REMIT PAYMENT AND FORMS T0:
KATHLEEN RUSSELL REGISTER OF WILLS
243 WEST RIDGE STREET CUMBERLAND CO COURT HOUSE
CARLISLE PA 17013 CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
EVERGREEN INVESTMENTS provided the Oepa rtaent with the info raation below, which has boon used in celculatinp the
poten4lal tax due. Reea rds indicate that a4 the death of 4he above-naaed decaden4, you ware a joint owner/beneficiary of this account.
If you feel 4he inf ore ation is 3nearreet, please obtain mitten correction frog the financial institution, attach a eopv to this fora
and return ib to the above add rasa. This account is taxable in accordance with the Inheritance Tax laws of the Coaaonwealth of
Pannav lvsnia. Pluc call l]iT) 78]-832] with auctions.
COMPLETE PART 1 BELOW N SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. Date 03-03-2008 To ensure proper cratlit to the account, two
ESteDll3hotl copies of this notice oust aecoapanv
pavaent to the Repistar of Wills. Make check
Account Balance ,S 1 32.9 0
48, payable to "Register of Wills. Apant".
Percent Taxable X 25.000
NOTES If tax paveents era aatle within three
Amount Subject to Tax $ 12,033.23 aonths of the tleeedant's date of death.
Tax Rate )( 1j deduck a 5 percent discount an the tax dua.
A^v Inheritance Tax tlue will becoae tlelinauent
Potential Tax Due 5` 1,804.98 nine aonths of ier the date of death.
P
T TAXPAYER RESPONSE
~
1
CHECK
ONE
BLOCK ~/.p p9.
ONLY ~(Li~
Tha above inf oraa4ion and tmc dua is correct.
Resit pavaent to the Resister of Wills with two copies of this notice to obtain
a discount or avoid interest, or chock box •'A" and rata rn this notice 4o the Register of
Wills and an official assessa ant will ba Sssu ed by the PA Dev artaant of Revenue.
The above asset has been or will ba repo rtetl and tax oaitl with the Penn svlvanie Inheritance Tex return
to be filed by the estate rep read ative.
C. ~ The above inf oraa ton is into rrect and/or debts and deductions ware paid.
Coaplat• PART 2~ and/or PART 3^ below.
PART IT incicatin9 a ciffa root
ralatio ns hip to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. A«ount Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts antl Deductions
6. Amcunt Taxable
7. Tax Rate
8. Tax Due
6 state
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
6 e
T X
8 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
DATE
Under penalties of perjury, I deela re that the facts I have reported abovef~a re t)r~u~~J,TTeprreet antl cJ
comp eta~.toAt he bask of my knowledge //and belief. HOME (~]/'/) "f 7V ~ 3 ~ ~ ~T
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