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HomeMy WebLinkAbout01-29-10 (3)PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES -~.... _, ,,_ AND FILE N0. 21 09-1059 Po Box zao6B1 ~ [ i` TAXPAYER RESPONSE ACN 09174474 WIRRISBURG PA 17128-0601 , +'_, ,- ~-- - DATE 11-26-2009 mEV-1543 IX AFP (OB-OB{ '- ~~-. 2Q1D JQ~ 29 PPS 12~ 02 n , ~-.~r ~.~t~iC~ .a- oj;Rr~H~~,, ~ ~~~~~~Tr q FRIEDA BRUCE 403 EISENHOWER DR CARLISLE PA 17013 EST. OF DALLAS C BOWERMAN SSN 257-32-0529 DATE OF DEATH 05-25-2009 COIINTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING © TRUST CERTIF. BANK OF AMERICA NA 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. 68100100574350 Date 06-28-2004 To ensure proper credit to the account, two Established copies of this notice wust accompany Payment to the Register of Wills. Make check Account Balanee $ 7 313.28 ~ payable to "Register of Wills. Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax $ 7,313.28 months of the decedent's date of death, Tax Rate ~( , 1 ~j deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TeX Due $ 1,096.99 nine months after the date of death. PART TAXPAYER RESPONSE •~.t` A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid i nterest, 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. ONE BLOCK ,,,r,,---------,//,,,//// B. The above asset has been or will ba 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 3~ below. PART If indicating a different tax r te, p19a ate ~ '~ ~ ~~~~4} ~i~~~ ~~ ~ ~~~ ,~ ` ~ b " ~~3~ ' relationship to decedent: '~l~r ~ ~ i f~ ~'h & i `' 4 ~ ~ `J T j ~y I n -C'I! K d i~ ~ ~ ~r ~~ ~ ~ i~~ ° ~~ r~ g~ b' ,"r TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS n` ~ s" £ 7 37 ~; I f LINE 1. Date Established 1 .{ ~.r ~ ~ ' ~ P w wwwwww 2. Account Balanee 2 $ 1~ $,;; ~y'~ ~ i~Yr fP MI P M~ t ~ w» t ~d ~ ~ ~ '»±±~ ' 3. Percent Taxable 3 X [ © , , 's, ~ '~ ~ - £~~ " t" ~ , '~ $ ~ E. ~'' 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ c 7. Tax Rate 7 X '~ 8. Tax Due 8 $ ' „ PART DEBTS AND DEDUCTIONS CLAIMED TOTAL CEnter on Line 5 of Tax Computation) 4 Und penalties of erjur , I declare that the facts I have reported above are t~ruJe,/ correct anlcd~ c ete to th b s of knowledge and belief. HOME ) ~'y ~ ~ ~ ~J WORK ( ) T PA IG T TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID