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Home My WebLink About03-31-10BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-,0'6±B•I~`~ „ _ ;t ZOtO~tR 31 Pty t= S~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~0 -- ACN 10115679 DATE 03-16-2010 C~E~~ ~~ ~~ {gip, -1 ~~(1 ANNE ~M-"G~A'~RA~1~~ i•.~._ , 2097 ASHBURY DR HARRISBURG PA 17112-1550 EST. OF ANTHONY T GRASHA SSN 167-10-3703 DATE OF DEATH 12-16-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17D13 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. WACHOVIA BK NA provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-nawad decedent, you were a joint owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1010120244971 Date 11-I6-2005 Established Account Balance $ 15 ~ 584 .79 Percent Taxable X 50.000 Amount Subject to Tax $ 7 ~ 792.40 Tax Rate X .15 Potential Tax Due ~` 1 ~ 168.86 To ensure proper credit to the account, two copies of this notice must accowparM payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE, If tax paywents are wade within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. A. ~ The above inforwation and tax due is correct. Rewit vaywent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of ONE ~ Wills and an official assesswent will be issued by the PA Departwent of Revenue. BLOCK B. ~ The above asset has been ar will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the estate representative. C. The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, lease state relatiohship to decedent: wilt 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 PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of periury, I declare that the facts I have reported above are true, correct and ~gcomplete to the best of my knowledge and belief. HOME C ~7~7 ) (Os~-~7 X-_ ~.'~7, ,~1rt a~ woRK c ) NdNE- yv~o TAXPAYER SIGNATURE TELEPHONE NUMBER DAT OF TAX ON JOINT/TRUST ACCOUNTS 1 I ~-/~ -zoo S' 2 $ /S S8 ~ .TY 3 X o 4 $ ~ 5 - B 6 $ ~ ~ X b 8 +~ DATE PAID PAYEE DESCRIPTION AMOUNT PAID BUREAU OF INDIVIDUAL TAXES PO BOX 280601 (; _ '~~~,: HARRISBURG PA 17128-0601 ~, ~_ ;,~y~3sas~C~r,coa-oi PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -~U`~~~~ ACN 10115680 DATE 03-16-2010 ZQ~Q ~~R 3 I P~ I ~ 57 C! ~~}s nr tORP~,",1'v'S `COURT ,~ ~~~:_, ~~~ , PA. ANNE M GRASHA 2097 ASHBURY DR HARRISBURG PA 17112-1550 EST. OF ANTHONY T GRASHA SSN 167-10-3703 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-nosed decedent, you were a point owner/beneficiary of this account. If you feel the infornation is incorrect, please obtain written correction from the financial institution, attach a copy to this fors 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1010163323891 Date 06-04-2007 To ensure proper credit to the account, two Established copies of this notice oust accompany Account Balance 15 897 90 payment to the Re9istar of Wills. Make check " . ~ payable to Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 7 948 95 NOTE: If tax payments are made within three ' ~ . months of the decedent s date of death, Tax Rate X , 15 deduct a 5 percent discount on the tax due. Potential Tax Due ~ 1 ~ 192.34 Any Inheritance Tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 -- ,.. ~. A. ~ The above infornation and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of ONE 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 0 N L Y to be filed by the estate representative. C. ~ha 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 rate, please state relationship to decedent: WIFE' _ 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 PART DEBTS AND DEDUCTIONS CLAIMED Under penalties of perjury, I declare that the facts I have reported above are true, corprect and ~cyomplete to the beps~t of my Dknowledge and belief. HOME C -7~7 ~ (isz- 77D~ _ l1LVt~t.2 YID ~ .~'J/~_2,Q~c,4 WORK ( ) /yo~/e_. 3 2 u-~O TAXPAYER SIGNATURE TELEPHONE NUMBER DATE OF TAX ON JOINT/TRUST ACCOUNTS 1 (o ~~/ Lpo7 z S /.S, 89 7 9D 3 X O 4 ~ ~ 5 - 0 6 $ Q 7 X 8 +~ DATE PAID PAYEE DESCRIPTION AMOUNT PAID f~j f4~t ~^ ?~~~ ~,F~ ~/ ~2 •~: ~~ ~5.~ i;3 t.".{ •~ {.i ;a~ ~,~ :.i9 tJ 5k ~3 ~F '~'. ~- ~" ~. .~~ ~~'~ ' 1s _~ 3 _~ ,~ ~1 '{ 7~ ~I f w ~. ~~ ;~ ~~ L 'v ~ ~ ~, y\ ~ , ~ A _ ~ \ ~ V v ~ ~ s ~ 0 L ~, ~ ~ ~ ~y ~} ,,~U~i,,t~~ 1u,C ~bt ~ J~, ~~~~7 LS :l ~~ 1 E 21`~~ 01~L -,-~, , ,~ k i J , ' ~ ~ ~ .L : ~ .: :. M ~I~ r ,.,w i :r N ~y ~~~ r~ :% . ~; '= a"~' ~ ~~ { ,, ti t