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Home My WebLink About08-25-09 (9)BUREAU OF INDIVIDUAL TAXES PO BOX 280601 - HARRISBURG PA 17128-0601 ' REV-1543 EX AFV PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE N0. 21~~~y3 ~TAXPAY~R RESPONSE ACN 08163190 DATE 12-22-2008 L~~g ~~ ~~ !~' ~~ I~~ST. OF RUTH M SWARTZ SSN 222-05-5506 nyCFrr~r DATE OF DEATH 11-30-2008 ~~~r-;t ; ; r~ ~, 1~T COUNTY CUMBERLAND ~`~ °,'`- --~ n" REMIT PAYMENT AND FORMS T0: - _ !a. PATRICIA YOUNG REGISTER OF WILLS 812 W KELLER ST ~ CUMBERLAND CO COURT HOUSE MECHANICSBURG PA 17055-4028 CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. PNC BANK 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 call C717) 7B7-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000031900178474 Date 02-02-2006 7o ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 6,838.75 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 3, 419.38 months of the decedent's date of death, TaX Rate X .045 deduct a 5 percent discount on the tax due. 1 5 3.8 7 Any Inheritance Tax due will become delinquent Potential Tax Due $ nine months after the date of death. PaT TAXPAYER RESPONSE 1 FAILURE Tn RESPOND WILL RESULT IN AN OFFICIAL TAX AS5 5SMENT A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE BLOCK NL B. R The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return O Y to be filed by the estate-~epPaeen#ati~ra_ Joint Owner C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state a relationship to decedent: TAX RETURN - COMPUTATION LIN'e 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 QFFICIAL USE q `Y Q AAF PA DEPARTMENT OF REVENUE OF TAX ON JOINT/TRUST ACCOUNTS PAD 1 2 +fi 3 X 4 5 6 +fi 7 X 8 +~ 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complet to t best of my no7rledge and belief. HOME ( 717 ) 766-1363 ~/ , WORK C ~J ~ ) Sf CJ TAXPAYE SIGNATURE ( TELEPHONE NUMBER ATE TOTAL (Enter on Line 5 of Tax Computation) S