HomeMy WebLinkAbout05-20-10BUREAU OF INDIVIDUAL TAXES ,.1.,
PO BOX 280601 ,
HARRISBURG PA 17128-0601
REV-1543 E% AFP FOe~beti''-.
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
_ AND FILE N0. 21 10-0261
-Y'AC~F?AYER RESPONSE ACN 10125325
~,, DATE 05-05-2010
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CAROL MAURET
3541 MARCH DR
CAMP HILL PA 17011-5011
EST. OF MARTHA BONIN
SSN 205-26-2115
DATE OF DEATH 02-25-2010
COl1NTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
CITIZENS BANK OF PA 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 (717) 787-8327 wih questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6222919735 Date 09-13-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance tifi 2,440.27 payable to "Register of Wills. Asent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 1 ~ 220.14 months of the decedent's date of death,
Tax Rate ~( 1rj deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 183 • 02 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ^ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of
Wills and an official assessment will be issued 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 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 ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE I. 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 +fi
5 -
6
7 X
8
PAD
OFFICIAL USE DNLY ~ AAF
PA DEPARTMENT DF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are/true, correct and
comp to to t[hpe best of my knowledge and belief. HOME C 7/ 7 )7 (0~- 7~ T~
OT G.-ce~e.~tJ ~ W O R K ( 7/ 7 ) G -- ' o - o
~X YER SIGNATURE TELEPHONE NUMBER DATE G.~~`
TOTAL CEnter on Line 5 of Tax Computation) s