HomeMy WebLinkAbout12-08-09BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
ly1RRISBURG PA 17128-0601
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PENNSYLVANIA INHERITANCE TAX
rr INFORMATION NOTICE
4' ,^~;~;~,~ AND FILE N0. 21 `d~- II35
;, , ti ,F;;,PAYER RESPONSE ACN 09168765
~ v; +'tr:..'' DATE
10-23-2009
10Q9 DEC -8 QM ! ! = 23
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LOUIS A WINTERS
612 GOLF CREST LANE
DAVENPORT FL 33837
EST. OF JANICE C WINTERS
SSN 207-34-8222
DATE OF DEATH o7-20-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAYINGS
® CHECKING
TRUST
CERTIF.
WACNOVIA BK NA provided the Department with the information below, which has been used in calculating the
Dotential tax due. Rego rds indicate that at the death of the above-named decadent, you were a 9oint owner/beneficiary of this account.
If you foal the infonation is incorrect, please obtain written correction frog the finanei al institution, attach a copy to this fora
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
M1pr*ari.arnia-• t•S emsaraIl (Tt T7 707-0327 with questions. -
COMPLETE PART 1 BELOW R SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1010187826989 Date 04-17-2008
Account Balance
Percent Taxable
Amount Subieet to Tax
lax Rate
Potential Tax Dua
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Dobts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Duo
PART
0
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
•
Under penalties of par~ury, I tleclare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief.
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TAXPAYER SIGNATURE WORK ( 1 ~~~
TELEPHONE NUMBER DATE
Established
$ 9,247.73
X 50.000
$ 4,623.87
X .15
S 693.58
2 ~
3 X
4 S
5 -
6 S
7 X
8 ~`
Ta ensure proper credit to the account, two
copies of this notice oust aecomparbl
Payment to the Reoister of Wills. Make chock
pavabl• to "Re6ister of Wills. Agent".
N07E: If tax payments are pads within three
months of th• decedent's data of death,
deduct a 5 percent discount on the tax dua.
Arty Inheri tane• Tax due will become delinquent
nine months after the dat• of death.
DEBTS AND DEDUCTIONS CLAIMED