HomeMy WebLinkAbout12-21-09 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES r„q ~, --...~,„ .•,,,- AND
Po BOX 280601 .~-~ ~~ ~*~~ ~AXPAYER RESPONSE
HARRISBURG PA 17128-0601 -
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REV-1543 ~C'AiR~fbb=0b~i "~~ 4
FILE N0. 21 "7~~"~~~'~
ACN 09176574
DATE 12-02-2009
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NANCY WHITMAN
7 ANDES DRIVE
MECHANICSBURG PA 17055
EST. OF EVA KIMMEL
SSN 168-36-2802
DATE OF DEATH 11-18-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
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 ]oint 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 C7/7) 787-8',27 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 200476-00 Date 01-02-2001 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 707.2$ 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 $ 353.64 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 $ 15 • 91 nine months after the date of death.
PART TAXPAYER RESPONSE
1 i ; •~,,% 9%F%:ri%': C ~F: 11~:%f ~ !,•'ri'i ~ly'ii~`/f~l /.:•%fc;%':~N:.N/.F~,/.':•14:.'%'{~'.7` `,:• f {fp' . ~/. :://~.: ..~~. , fGli• ":~~' :H+' ~.k'f'. ~ '.,F'.//.Yi
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,! :: :. 4r: .a r' .1:1, ''/,x~! ,,.: F:?'' .......... .. ....//. /•. `, .1~%JrN. NF.%S. • ~ ,. ~lifi./'I.: f.•~` :•:'Y .~~`O"nf, r`i..i!fif:!n. C N ..,.:' ,i %• i ,f
A. (~he above information and tax due is correct.
uu 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
Wills and an official assessment will be issued by the PA Department of Revenue.
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 ~ F';,~.'~ ! , ': ~•. r•'' °?
~{~J! f`f
2 relationship to decedent: r ;,
i. , ~ . /~.~s,
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS :~ . .. •y,,l,~.~ .•''•` '' •?': • ~~! ~.!fr
LINE 1. Date Established 1 ~nf1%~ •~'`• ~ `~'
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2. Account Balance 2 ;~`..}:~` ••! ~`•F ''` • r•^'~ ' #
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3. Percent Taxable 3 ~ f~•°• "~ ~ ~ • '~ ! '~ f ~• ` ~`~
4. Amount Subject to Tax 4 $ ,~Ff i.~:~:~. '~< <;~:;~ f ,f ``~'% ~• '~~'`%'~!%!%"!
5. Debts and Deductions 5 - :~kyr,~r~'''f' ,~{
6. Amount Taxable 6 ~ •~~ „~y~,l~~ nf. r::r,~,~•,'~.,,'`,~%! .~.•. ..~~':~ I.~'"•~~~~r,.~.~{.x,``~„
F'l yk~?",~•~~r f{'~ J"~ ,ff•Y.'lys,'. ' /: ~, .'Y `{ +.fr`#:' ~,•f,•,}yj
7 . Tax Rate 7 ~ • r ~:''..~` r ~k.• °! ,r,F,ti: , ~ ,<
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8. Tax Due 8 •,~r+~~y~/y y ~ ~f.,,`,~ .,...~ .~.'~!', ....,~.~' ' .~~•`~•, .~,`.F<><
G',::";'/d'{% ",/r.. ,G':;f.`::{#I:. i l,F%l:,f:f%,'.,?f.;'`Y!.•'.': `y'•'}. /:: ~?!A•'.!./.6:.1• .J/,1,. `/G'.,.%i~':Y ',1,5,'3„C.•:,2;i,
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 tr/ue/, correct and
complete to the best of my "k'n~owledge and belief. HOME C ~~ ~) ~ ~P h q O9
-~Z'~x.~. ~'G~~~L WORK C
TAXPAYER IGNATURE TELEPHONE NUMBER DATE