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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTIC°
BUREAU OF INDIVIDUAL TAXES AND ~ FILE N0. 22 ~~ -(y Lv0 ~
Po Box zaB6o1 TAXPAYER RESPONSE ACN 09129178
HARRISBURG PA 17128-0601
DATE 05-13-2009
REV•1543 EX NF'P (OB-OB)
VICKI MCNAUGHTON
8 BOXWOOD LANE
CAMP HILL PA 17011
EST. OF EMMA BAILEYS
SSN 186-14-1304
DATE OF DEATH 0.5-02-2009
COUNTY DAUPHIN
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
DAUPHIN CO COURT HOUSE
HARRISBURG, PA 17101
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU 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
Penn syivania. Please tali :7171 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FDR FILING AND PAYMENT INSTRUCTIONS
Account No. 201415-11 Date 01-31-2001 To ensure proper credit to the account, two
Established copies of this notice must accomvany
Account Balance $ 1,067.47 Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 533.74 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 24.02 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
~T`~r..
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain ="~%~?~'~;;I~i!' ~~°i~-:~!t FII`~i
CHECK a discount or avoid interest, or check box "A" and return this notice to the Register o~~3it+7!-:: ~., ~f~{+3~~'
Wills and an official assessment will be issued by the PA Department of Revenue. k°,a~jl~..aj- 01 viii:
C ONE ~ ~'--,:- + , ' ;~U-=
l~f r C'. €Ji i'fi~3f~= 6
BLOC K B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritence~ Yak return
ONLY to be filed by the estate representative. ~~.~L:L'I;1;~ ~.i_~ir;t,~9 F°~
,;:-
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 pFFICIAL USE ONLY ~ AAF
relationship to decedent:
Q PA DEPARTMENT OF REVENUE
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 I
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 CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
c 1 to bes o my knowledge and belief.
PImP-~ ~ 1~1_.. f HOME C ~ ~,
WORK ( ~
DATE
TOTAL (Enter on Line 5 of Tax Computation) S
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
08/07/2009
Ms. Sandra Snyder
Register of Wills
Dauphin County Courthouse
Harrisburg, Pa. 17101
Telephone
717-787-3930
Re: Estate of EMMA BAILEYS
File Number: 2109-0709
County: Cumberland
Date of Death:05/02/2009
Dear Register of Wills:
The subject decedent legally resided in Cumberland County as of the date of death.
Accordingly, you are authorized to cancel file number 2209-0601. All matters concerning this
estate should be maintained under Cumberland County File Number 2109-0709.
All original Inheritance Tax documents for the subject decedent should be forwarded to
the Cumberland County Register of Wills; however, you may wish to retain a copy, including
photocopies of all receipts for the collection of Inheritance Taxes in the subject estate which
have been issued by your office.
Please contact me at the telephone number above if you have any questions.
i~„_. -~
ncerely,
~.~
`~i~~ 1 1
t~ ~'/;
Claudia Maffei, Supervisor
Document Processing Unit
Inheritance Tax Division