HomeMy WebLinkAbout11-23-09BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 ~ '~I
''" ~'~~ `'`' `~~AX~AYER RESPONSE ACN 09172447
REY4scs IX AFP ~'a~i . C.4"`. '.Ji ~ ~~' ~ '-~ DATE 11- 0 6 - 2 0 0 9
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ORPHAN'S C~tJRt
CUB r-`-; ~' ~,+L; ;.,'~.. PA
KRISTINE N PALMER
25 SHEPHERD RD
NEWVILLE PA 17241-1102
EST. OF HELEN K PALMER
SSN 226-56-3570
DATE OF DEATH 10-14-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
FARMERS ~ MERCHANTS TRUST CO provided the Departwant with the inforwation below, which has been wised in calculating the
potential tax due. Records indicate that at the death of the above-mewed decedent, you were a joint owner/bemef~ciary of this account.
If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of
__...______P~nacy~l=FaA-ia.---Pl~oaca--eal~-(~7-133 i87-Sb27-wiEA gnastions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUICTIONS
Account No. 33-28139 Date 02-06-2008 To ensure proper credit to the account, two
Established copies of this notice wust accowpaw
Account Balance 1 , 141.84 paywent to the Register 0f Wills. Make check
payable to "Register of Wills, Apent".
Percent Taxable X 50.000
NOTE: If tax paywents are wade within three
Amount Subject to Tax ~ 570.92 months of the decedent's date of death,
Tax Rate ~( , lj deduct a 5 percent diacount on the tax due.
Any Inheritance Tax due will becowe delinquent
Potential Tax Due $ 85.64 nine wonths after the dake of death.
PART TAXPAYER RESPONSE
1^
A. ~ The above information and tax due is correct.
Rewit paywent 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
Wills and an official assesswent will be issued by the PA Departwant of Reivenue.
C ONE
BLOCK B. ~ The above asset has been ar will be reported and tax paid with the Pennsvlvani'a Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~)(~ Tha above inforwa ion is incorrect and/or debts and deductions were paid.
/" Cowplete PART 2~ and/or PART 3^ below.
PART If indicating a different tax rate, please state ~'~
relationship to decedent: ~
:
£
~,,
~; ~
TAX RETURN - COMPUTATION OF TAX ON JOINT/
TRUST AC
COUNTS ''"~~
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2
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LINE 1 . Date Established 1 i~ (o 4
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2. Account Balance 2 $ ~~~~, (
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~ 7 '
3. Percent Taxable 3
X
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'a i
4. Amount Subject to Tax 4 $ ~J' 7~ ~ Z-
5. Debts and Deductions 5 - I ~ ~ C ~~
6. Amount Taxable B $ ~d
7. Tax Rate 7 )C '-~ ~'
8. Tax Due 8
PART .DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
vn~ L .- ~"M ,q-~rl a O,
U G /Y L n/' C L'
rorAL center on Llne s of rax ~omputation~ ~ ~ / ~~,~-
Under penalties of perjury, I declare that the facts I have reported ^a~bovye are tru/e, correct and
complete to the t of my knowledge and belief. HOME C / ~ ( ) ~7(! ~~~~
WORK ( )
TAXP YE SIGNATUR TELEPHONE NUMBER DATE
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