HomeMy WebLinkAbout12-03-09PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AN D
PD Box zao6gl TAXPAYER RESPONSE
HARRISBURG PA 17128-0601
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009 DECEMBER 03 EST. OF MARY F HOOPER
CL;IRKC.>I, SSN 008-10-6585
C)RpH~1'~~' COt1RT DATE OF DEATH 09-28-2009
C_L'~lI3F.RI ~1~D (.<~.> P.'~ COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
SUSAN M HOOPER REGISTER OF WILLS
APT 301 CUMBERLAND CO COURT HOUSE
423 WALNUT ST CARLISLE, PA 17013
HARRISBURG PA 17101-1912
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU 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 joint 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 C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0008106585-S4 Date 12-1 7-1996
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance
$
1
263 75 payment to the Register of Wills. Make check
"
, . payable to
Register of Wills, Agent".
Percent Taxable X 16 .667
Amount Subject to
Tax $ 210
63 NOTE: If tax payments are made within three
. months of the decedent's data of death,
TaX Rate X .045 deduct a 5 percent discount on the tax dua.
Potential Tax Due
$ 9
• 48 Anv Inheritance Tax due will become delinquent
nine months after the date of death.
P
T TAXPAYER RESPONS E
~
1 ~ ,.
,..
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with tw a copies of this notice to obtain
C HECK a discount or avoid interest, or check box "A" and return this notice to the Register of
Wills and an official assessment will be issue d by the PA Department of Revenue.
C ONE
BLOC 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 ba 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 rat , please state r-;
3
a relationship to decedent: ` ~~`f ~;
' x #~
E'y
~
~~
TAX RE TURN - COMPUTATION OF TAX ON JOINT
/TRUST ACCOUNTS ~i
°~~•.~~d }~-~~~~`
'~' ~~~~~~~
~
LINE 1. Date Established 1 - q
~ - 1 ,
,.a. ~ ~4 r' ,'¢ s. { n~~ iii ~y V,~~~ii 1~ ijs,!~
x ~ ~-`'" "•`'
~
2. Account Balance 2 $ ~ r,~ . ~ 3. ~~ ~
', ~ ~ ; ~ ~ +
:~~r
ww»w wwrr
3. Percent Taxable 3 X i~ a ~0~01 ~ ~~y~s ~~f
'"
4. Amount Subject to Tax 4 $ , ~ l D • (o.~ n
4 ;,,~;,; ~~ °~ _~~~''
5.
Debts and Deductions 5
- ~,
~ IS.
7~
r,.)'' .~ ' li ~~~5'x~~' ~~~~ } i~~,~'
`'
6. Amount Taxable 6 ~ di 0~
_ ,
6 ~ ~ ~ E%~'~E' •
7. Tax Rate 7 X e D KS ¥
8. Tax Due 8
$
O.OO
'~'.'`m
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
~w~eru \ (~ n
- (O; `t'v4cru 1 cl.cvn v'<fa Ce
0- 'L ~ C~MUu wnt W [OP 'D
:u:NL lCnter on Line 7 or lax 6ompuLailOn) S tt~~ ~ '~
Under penalties of perjury, I declare that the facts I have reported above are true, correct and /
co late to the bas of my knowledge and belief. HOME C '1~ ~ ) ~C~B '~ ~~7~
- ~,U c-_. ~ • ~ WORK C 111 ) C~ - ~ ~ 1-30-0
TAYPAVFR CTf~NATIIRF TCI CPUnuC AIIIMIICD nwT~
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FILE N0. 21 .D9.I~a~J
ACN 09169139 /
DATE 10-26-2009