HomeMy WebLinkAbout11-02-09 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES ; ; -~ _ ~'~~ ~+~ AND
Po Box zao6ol #' -~~'~' "~''~~ ' ~'~~ TAXPAYER RESPONSE
HARRISBURG PA 17128-0601 -; E,; ~":, ,
REV-1543 EX AFP C08-08)
FILE N0. 21 08-0744
ACN 09004369
DATE 10-16-2009
EST. OF LOIS M LANTZY
SSN 161-34-2046
DATE OF DEATH 07-03-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
2~0~ NOV `2 PM ~ ` 39
~~~~~
C,P~~U'S ~Qi~RT .
~~ ~.
PAULINE C ~H~EttY
a. s 5 -V E
~,~..~ --09 ~-.-__.,.~A..,.i.7050
3~1~6 f~~~l h'~vv// ~'~
WACHOVIA SECURITIES 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
Fennsyivania. Fisasr call C717) 787-832 wcrlrlt au~stions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account Balance $ 20 , 01 6.87 payable to "Register of Wills, Agent".
Percent Taxable X 33.333
Amount Subject to Tax
$
6
672
22 NOTE: If tax payments are made within three
.
, months of the decedent's date of death,
Tax Rate ~( ~ 12 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due $ 800.67 nine months after the date of death.
PART TAXPAYER RESPONSE
f ~ ll :. . ~~ • ,~~~~w1.•ri ~. "4i . fy. !'yi4 ' 'ti' .F" '' lr/...,i FY.
Account No. Date 06-13-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills Make check
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
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.
0
DATE PAID PAYEE DESCRIPTION
C. he above i nforms ion is incorrect and/or debts and deductions were paid.
~
Complete PA RT 2
and/or PART 3~ below.
PART If indicating a different tax rate, please state •
.~,,~i~,
relationship to decedent: y
,•
?~,r~r,`~r~"
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~
~% ~•~~~
4
LINE 1. Date Established 1 '; y ~~~ F
r
2.
Account Balance 2 $ , i . ,,~
.~ ;F
3. Percent Taxable 3 X f' ~ ~ .~ '"
$ N '~%
4. Amount Subject to Tax 4 r.
,
5. Debts and Deductions 5 - i ~°'~~'~7~ ~ `f` f "~
~
6. Amount Taxable 6 $ .••;~°'A• '~`"~ ~''~°~-~
7. Tax Rate 7 X y ~~!~~ ~F $ r~
8 T a x D u e g $ ~%
~:
,,~:.~,F{:.J'° j d,~ ,
. ~
PART DEBTS AND DEDUCTIONS CLAIMED
AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete they~ best oa~f my kn ledge and belief. HOME C, Q~. ) ~~~-~3ag
C~•t~"r ~ WORK C
-XPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) S