HomeMy WebLinkAbout12-01-09PENNSYLVANIA INHERITANCE TAX pp
INFORMATION NOTICE FILE N0. 21-~D' ~~,~
,,,. ,~ .~ --,~ r- ,AND
BUREAU OF INDIVIDUAL TAXES '~A~EPAYER RESPONSE ACN 09173764
PO BOX 280601 ~~a ~ s-,~
HARRISBURG PA 17128-0601 ~ ~~ ~ DATE 11-19-2009
,__
REV-1543 E% AFP
_, ~~ ~: ~~
E T. OF SARA J BRYTZ
C~~R~ ~ SSN 200-16-8925
Q~j~-~~{'~ ~Q~~r DATE OF DEATH 10 -17 - 2 0 0 9
GUfUB~q~u~~, ['~~ COUNTY CUMBERLAND
l ~~" (/'REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
DORIS BRYTZ CUMBERLAND CO COURT HOUSE
2820 MYRTLE DR CARLISLE, PA 17013
MECHANICSBURG PA 17055-5947
TYPE Ur
ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU provided the Department with the information below, which has been used in calculating the
Iftvoulfeelatheuinformation isdincorrectt please obtain writtenbcorrectiondfromethe financial institution,/attachcaacopvftohthiscformt
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 C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0200168925-S4 Date 06-11-1991 To ensure proper credit to the account, two
copies of this notice must accompany
Established payment to the Register of Wills. Make check
Account Balance $ 4,529.29 payable to "Register of Wills, Agent".
X 1 6 . 6 6 7 NOTE: If tax payments are made within three
Percent Taxable
Amount Subieet to TaX $ 754.90 months of the decedent's date of death,
. 0 4 5 deduct a 5 percent discount on the tax due.
TaX Rate X Anv Inheritance Tax due will become delinquent
Potential Tax .Due $ 33 • 97 nine months after the date of death.
PART TAXPAYER RESPONSE
D aIL E Tp RESPOND WILL RESULT TN AN .OFFICIAL TAX ASSE5~MENT
A. ^ The above information and tax due is correct.
Remit vavment to the Register of Wills with two copies of this notice to obtain
a discount ar avoid interest, or check box "A" and return this notice to the Register of
CHECK 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
C ONE
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 a below. - r
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subiect to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
n r~Y nua
PART
DATE PAID
OFFICIAL,
x PA DFPAi2TM
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION
u
TOTAL CEnter on Line 5 of Tax Computation)
~° "'~-`_
AMOUNT PAID
.,..`nn .
~,Z~ c"r"
33/-"
Under penalties of perjury, I declare that the facts I have reported above are true, co~ic~~nd
HOME C ~'"
complete to the best ~ my knowledge and belief. 7 ~ ) ~~~~ n J
WORK C 7/7 1 ~~' ~ ~ /~ ~ Te,rC~' G~%
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
3 X
4 $ _
5 ~.~~~
X .._.~., __.--
B $ ._.. ~~
f`
~„
t
f~,~
L}„
w
~ ~
..{
~~:
-.r
:..~,
a
r t L.
E
~~
o ~
N o0
~ ~~
~ ~
7"'+ ~ a
`'
Q ~
~ ~
i
~ ~ ~~ '
t ~. ~ •x
~/~i H P
.' ~ ~ ..~
A. o .~
N U I"
0f9 v
.~.
,^^ .`
~/ ,, G
.~ ~ L
~ ~
;~ ~ ~~ ~
~_
D ~•'•!
__ ~C/)~ iTi
~~~ ~
i ~ ~,.~
~ ., 3 ~ i,~
~ v~.~~
•: i :{
.?~ ~ •rd
c~ ~ t:1
0
c.+ fem..
.~