HomeMy WebLinkAbout12-08-09 (2)reNNSYLVANIA INHERITANCE TAX
WACHOVIA BK NA provided the Department with th• information below, which has been used in calculating the
votential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/beneficiary of this account.
If you teal 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
PennaYlvsnia. Please. tali L737) 787-B327 with nuastiohs.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1010187826989 Date 04-17-2008
Establlshed To ensure proper credit to the account, two
copies of this notice must accomparry
Account Balance $ 9, 247.73 paywent to the Raaister of Wills. Make chock
P ereent Taxable X payable to "Register of Wills, Agent".
50.000
Amount Subject to Tax $ 4,623.87 NOTES If tax payments era made within three
Tax Rate X months of the decedent's date of death,
Potential Tax Due • 00 deduct a 5 percent discount on the tax due.
$ . 0 0 Any Inheritance Tax due will 6eeome delinquent
PART nine months after the data of death.
~ TAXPAYER RESPONSE
A• ~ The shove inforaation end tax due is correct.
Remit payment to the Raaister of Wills with two copies of this notice to obtain
C CHECK ~ a discount or avoid interest, or check box "A" and return this notice to the Reoister of
ONE Wills and an official assessment will be issued by the PA Department of Revenue.
BLOCK B. ~ The above asset has been or will be re orted and tax
ONL Y to be filed p Paid with the Pennsylvania Inheritance Tax return
by the estate representative.
C. ~ Tha above infona ion is incorr ct and/or debts end deductions were paid.
Complete PART 2~ and/or PART 3~ below.
PART If indieating a diffa.rent tax ter, pl a e st e
relationship to decedent: _~ 1/~~/-t~,J%~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Establlshed 1
2. Account Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5
6. Amount Taxable g $
7. Tax Rate T X
8. Tax Due 8 $
PART
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE
Under
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES /'~ v' r
PD BOX 280601 11<.L^~~_G r AND FILE NO. 21 ~~j~j. /~3S
HARRISBURG PA nl2e-osol - FA~YER RESPONSE ACN
~~ f,i~., r'~ ~r. ~ 09168765
~` `'~' ~' ~`~i~RLVISED NOTICE ~ ~ ~ DATE
eev-ucs a Arv toe-eu 11 -23-2009
10ff9 f)EC -8 An f f 123 TYPE OF ACCOUNT
EST. OF JANICE C WINTERS ~ SAVINGS
CLEP,K ()~ ssN 207-34-8222 ® CHECKING
~~~~ ~Q~~j DATE OF DEATH 07-20-2009 ~ TRUST
(;(f~RFf?I~4~~(~ ~(`'~. PA COONTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
LOUIS A WINTERS REGISTER OF WILLS
612 GOLF CREST LANE CUMBERLAND CO COURT HOUSE
DAVENPORT FL 33837 CARLISLE, PA 17013
DESCRIPTION
AL (Enter on Line 5 of Tax
on] w
AMOUNT PAID
mercies or perjury, I declare that thm facts I have reported above are true, correct a d
to the bast of y know dge and belief. ,G
~'~' HOME C g~i3 I ~2 / -3S Z~
~- WORK ( 1
SIGNATURE TELEPHONE NUMBER Z-'oS-O`j
DATE