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HomeMy WebLinkAbout04-07-10 (2)INFORMATION NOTICE AND BUREAU OF INDIVIDUAL TAXES , ~ n~ r AYE R RE S P O N S E PO BOX 280601 ~~r^('~• HARRISBURG PA 17128-0601 ,y.~~ '-~ ~-" - V REY-1543 IX 11F}~~.°Y.~4~ i '~~` 1- ~7 h' t h PENNSYLVANIA INHERITANCE TAX ~p~0 APR -7 PM 2~ Q8 ~~~ O~ GU~ID CA., PA DOLORES E DLUZESKI 6038 WILLIAM DR MECHANICSBURG PA 17055 FILE N0. 21.1' a3~7 ACN 10115045 DATE 03-16-2010 EST. OF STANLEY J DLUZESKI SSN 165-20-6131 DATE OF DEATH 12-16-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. WACHOVIA BK 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 Saint owner/beneticiary of this account. If You feel the information is incorrect, vlease 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 7_aws of the Comaonwealth of Pannrilvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1000323096237 Date 11-06-1989 copiesuof thisenoticelmust acco•panvnt, two Established t to the Register of Wills. Make check Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due $ 523.11 X 50.000 g 261.56 X .15 ~ 39.23 paymen payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will becowe delinquent nine months after the date of death. PART . nn. .-. -- - - - - - A. ~ The above information and tax due is correct. f i this notice to obtain es o Remit payment to the Register of Wills with two cop "A" and return this notice to the Register of a discount or avoid interest, or check box issued by the PA ll b Department of Revenue. CHECK e Wills and an official assessment wi C ONE t has bean or will be reported and tax paid wit h the Pannrilvania Inheritance Tax return BLOCK B. ~ The above asse 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deduction s were paid. Cowplete PART 2~ and/or PART 3~ below. PART If indicating a different tax ~ o u P~ ase state relationship to decedent: ~~~! TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 $ 5 6 '~ ~ ~( • © 0 B $ . Q7 O DEBTS AND DEDUCTIO S PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L1na 5 of Tax Computation) ~ U er penalties p jury. I declare that the facts I have reported above are true, correct and ~~ ~ co ate o the est o my knowledge and be ef. HOME C ) WORK C ) ~~'~~ TELEPHONE NUMBER DATE TAXP ER IGNAT