HomeMy WebLinkAbout07-17-09PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
Po Box 280601 r r- TAXPAYER RESPONSE
HARRISBURG PA 17128-06D1 _
~'I I ` .K ;-~ ~~ ~` REVISED NOTICE
REV-1543 EX AFP~f UB?58~' 3 ~- ` '~'"
FILE N0. 21 c~i CLa:4~J
ACN 09135802
DATE 06-12-2009
~Q~g ~~L ~ ~ ~~ ~~ ~ 1 EST. OF JENNIFER S MANDICH
SSN 186-50-3689
~~~~~~fJ~ DATE OF DEATH 12-20-2008
Q~F,~-!,~'~'S ~CU~3 COUNTY CUMBERLAND
,~ t ,. _ ~ I/-~, REMIT PAYMENT AND FORMS T0:
BRENT D MANDICH REGISTER OF WILLS
3 W COUNTRYSIDE DR CUMBERLAND CO COURT HOUSE
BOILING SPRINGS PA 17007 CARLISLE, PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
BANK OF AMERICA NA 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 joint owner/beneficiary of this account.
If you feel the information is incorrect, please 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
Pennsylvania. Please wll C717) 7B7-8327 with questions.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000570865683 Date 01-06-1992 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 $ 61 , 273.56 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NDTE: If tax payments are made within three
Amount Subject to Tax $ 30,636.78 months of the decedent's date of death,
TaX Rate ~( , 00 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ .00 nine months after the date of death.
PART TAXPAYER RESPONSE
URE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
FAI
L
A. RR
--S~
~y~ The above information and tax due is correct.
II~~ Remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART L.J below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 +~ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 '~ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS C AIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
l
Under penalties of perjury, I declare that the facts I have reported above are~t`ru[e~, correct and
mplete to the best of y knowl dge d belief. HOME C~}l~' ) C_.,~U"'~ ~3~
WORK C ~-l~ ) ~Z~ ~~lZ.~
.~*.... ...~.. .. ~..... r.. e.~ TCI CGLIA AIC Al11YDC[) PATC
TOTAL CEnter on Line 5 of Tax Computation) S
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