HomeMy WebLinkAbout09-25-09 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAxES AND F I LE NO. 21 U c1 O 1 Ool
Po eox zaB6ol - - :..TAXPAYER RESPONSE ACN 09152469
HARRISBURG PA 17128-0601 ` r.•
' ~ '* ~* }REVISED NOTICE * * * DATE 08-26-2009
REV-1543 EX RFP (OB~Q81 ' ~' i
2~~~ SEP ZS ~~ 2: ~8EST. OF PAMELA RHODES
SSN 193-46-1575
DATE OF DEATH 07-24-2009
C~-E~i~ ~-~~~ COUNTY CUMBERLAND
CR~~!1,1' ` f~'r~~ ~L~~-
i.. I_. y
C+1q ~' ~,~~ i REMIT PAYMENT AND FORMS T0:
BETTY ORT ~a, REGISTER OF WILLS
1160 MCCLURES GAP ROAD CUMBERLAND CO COURT HOUSE
CARLISLE PA 17013 CARLISLE, PA 17013
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
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 26167-00 Date 01-28-1981 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 $ 7,U58.24 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NDTE: If tax payments are made within three
Amount Subject to Tax $ 1, 176.4U months of the decedent's date of death,
Tax Rate X , 15 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 176.46 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
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
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 ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:_
TAX RETURN - COMPUTATION
LINE 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
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4 +fi
5
6
7 X
8
PAD
OFFICIAL USE DNLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties f rjury, I declare that the facts I have reported above are true, correct and
complet o be of my knowledge and belief. HOME C )
WORK ( )
TAXPA R IGNATURE TELEPHONE NUMBER DATE
~ TOTAL CEnter on Line 5 of Tax Computation) S