HomeMy WebLinkAbout05-13-10BUREAU OF INOIVIDVAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
R4Y-1545 OI IFP
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 10-0261
`j;,~ ~~~~YER RESPONSE ACN 10122108
ICIt y; ~~"? ~ ~ DATE 04-19-2D10
2010 MAY 13 AM I I ~ 43 EST. OF MARTHA G BONIN
SSN 205-26-2115
C~E(~ QF DATE OF DEATH 02-25-2010
QRp(-jq~}~g CQUflT COUNTY CUMBERLAND
CU~A~~~iJ~~1D ~^(j„ pq REMIT PAYMENT AND FORMS T0:
CAROL L MAURER REGISTER OF WILLS
3541 MARCH DR 1 COURTHOUSE SQUARE
CAMP HILL PA 17011-5011 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Departaent with the information bales, which has bean used in calculative the
potential tax due. Records indicate that at the death of the ebova-named decadent, you ware a joint owner/beneficiary of this account.
If you feel the information fs~ineorraet, please obtain written corroction from the financial institution, attach a copy to this form
end return it to the ebova add ass. This account is taxable in accordance with the Inheritance Tex laws of the Comaonweelth of
Pennsylvania. Please call C717D 7P7-8327 with euasti ons.
COMPLETE PART 1 BLOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000009202513331 Date 01-03-2005
Account Balance
Percent Taxable
Amount Sub~aet to Tax
Tax Rate
Potential Tax Due
Established
$ 5,389.21
X 50.000
$ 2,694.61
X .15
$ 404.19
~" mwre yrvper cre plL i0 Lne aLCOUOt, two
copies of this notice must accomaany
pevaent to the Register of Wills. Make chock
payable to "Register of Wills. Agent".
NDTE: If tax payments are made within three
months of the decedent's date of death,
deduct a 5 percent diseounL on the tax due.
Anv Inheritance Tax due will became delinquent
nine aonths after the date of death.
A. ~ The above information end tax due is correct.
Resit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interests or chock box "A" and return this notice to the Raaister of
ONE Wills and an official assessaent will be issued by the PA Departaent of Revenue.
BLOCK a~he ebova asset has boon or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONL Y o be tiles by the estate representative.
C. ~ The above info a ion is incorrect and/or debts and deductions ware paid.
Coaplete PART ~ and/or PART 3~ below.
PART
TAX
LINE
If indicating a different tax rate, please state
relationship to d~eedent:
RETURN - COMPUTATION
1. Data Established
2. Account Balance
3. Portent Taxable
4. Amount Subject to Tax
5. Debts and Deductigns
6. Amount Taxable
7. Tax Rate
8. Taz Due
OF TAX ON JOINT/TRUST ACCOUNTS
1-_
2 ~
3 X
4 +f
5
6 $
T X
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation] •
Under penalties of perfJury, I daelaro that the facts I have reported above are true, correct and ..~/nn-~~1
complete to ~thpe best of my knowledge and 6alief. HOME C7~7 ) ~G~ 7~7~ „~-t~
~~/.#f!s~, ~ ~isi..~~ WORK (~/T )7~0.~ 290 ~ .VM \V\
TAXPAYER SI A URE TELEPHONE NUMBER DATE