HomeMy WebLinkAbout08-13-09 (3)YtNNSYLVANIA 1NNtK11ANLt: IAA
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 OB-0409
PO BOX 280601 TAXPAYER RESPONSE AcN 09004266
IWRRIS BURG PA 17128-4601 -
"I`~, i"- DATE 06-12-2009
iar-ub. orafr •oe•~ae) -
?~~9 AU6 13 PF9121 ! I
CLEP'~( C~
ORPHtiPS'S C~J!)RT
ELIZABETH VANEK C~Pa",~rc~~,.,~'"~~' ~'n PP.
1920 WALNUT BOTTOM RD ~ '
CARLISLE PA 17015
EST. OF EMMA K MEYER
SSN 190-26-6982
DATE OF DEATN 04-03-2008
COUNTY CUMBERLAND
REMI7 PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVIN65
CHECKING
TRUS7
CERTIF.
EVERGREEN INVESTMENTS Provided the Dapa rtment with the inforaatf on below. which has bean used in calculatf np the
Ootentiel tax tlue. Raco rds indicate that at the death of the above-named decadent, you were a Io int owner/benef iciaro of this account
If you foal the info nation is incorrect, please obtain written correction Eras the flnen cial institution. attach a copy to this form
and Teturn it to tM above adtlrass. This account is taxable in sccordance with the Inheritance Tex lws of the Coaorweslth of
Pennsylvanim Pl ease call C]1]) 787-8327 wiM vuestions. - - __ _. __._ _. _.._ _. _ _. _
COMPLETE PART 1 BELOW R SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. Data 03-03-2008 To ensure proper cratlit to the account, two
Estab lishetl cooias of this notice oust aceomparo
Payment ko the Register of Wills. Mske chock
Account Balance 48,132.90 payable tp "Register of Willa. Apant".
P are ant Taxable X 25.000
NOTE. If tsx payments era msde within three
Amount Subject to Tax ; 12,033.23 aonths of the decedent's data of death.
Tax Rate )( , 1 5 tladuct a 5 percent discount on the tax due.
Any Inhe ritanee Tax duo will become tlalinauent
Potantlal Tax Dua g 1,804.98 nine months after the date pf death.
PART TAXPAYER RESPONSE
1^
A. ~ The above Snforaation and taz tlua is correct.
Rea it payment to the Rap inter of Wills with two cooias of this notice to obtain
r CHECK s discount or avoid interest, or cheek box •'A" and return this notice to tea Register of
I ONE ~ Wills and an offleLl asseasmeot will be issuetl by the PA Dap ertmmt of Revenue.
L BLOCK '~T~.e above asset hea been or will be reoortatl antl tax pa itl with the Pennsvlvsnia Inheritance Tax rata rn
ONLY _.~C~t o' ba filed by tho estate rap rasentativa.
C. ~ The above infena Son is into rraek and/or tlabts antl deductions wa ra paid.
Cwol ate PART 2~ and/or PART 3~ below.
PART If Sndi eating a different tax rata, please stsLa
relatlonsh3p to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Establishatl
2. Account Balance
3. Percent Taxahlo
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rata
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
2 ~
3 X
4 S
5
6 $
7 X
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Untler panalti es pf pa rjury. I daela re that the facts I have reported above are true. correct and
complete to tho hors~t of_ my know1kodpe antl be11eT. HOME C )
I~CIJY'tR~1~ WORK C-~l~ ~'lyU-yRl.3 g' -~
reyp R sr r_Ne IIRF TELEPHONE NUMBER DATE
TOTAL CEnter on Line S o4 Tex Computation)