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PENNSYLVANIA INHERITANCE T
~' ' ':LL- - ~`IN~ORMATION NOTICE
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BUREAU OF INDIVIDUAL TAXES •~ Itlflt) ~ AND
PO Box 280601 ~ /I r +"`T'AXPAYER RESPONSE
H1IRRISBURG PA 17128-0601
eEV_~ss ea ecw erwon 3 A V try. ~' ,
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~~~'_i,alU'S CLVPT
ELIZABETH J CALVER
1332 SCENERY DRIVE
MECHANICSBURG PA 17050
FILE N0. 21. /D ~ ~ Zd
ACN 10129627
DATE 05-24-2010
EST. OF HOWARD W CALVER t
SSN 118-12-2532 ~
DATE OF DEATH 05-08-201
COUNTY CUMBERLAND ra
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS '-'
1 COURTHOUSE SQUARE
CARLISLE PA 17013
A
TYPE OF ACCOUNT
~® SAVINGS
4 ~ CHECKING
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MEMBERS 1ST FCU provided the Departaent with the inforaation below, which has bean used 'n calculating the
potential tax due. Records indicate that at the death of the above-naaed decedent, you ware a point owner/benefi iary of this account.
If you foal the inforaation is incorrect, please obtain written correction frog the financial institution, attach a copy to this fore
end return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the C onwealth of
(~TIONS
Penn COMPLETEe PARTl 171BELOW s*7 SEE gREVERSE SIDE FOR FILING AND PAYMENT INSTRU
Account No. 5518-05
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rata
Potential Tax Due
Data LO-07-1985
Established
~ 4,804.08
X 8.333
~ 400.32
X .00
g .00
PART
To ensure proper credit t the account, two
copies of this notice aus accoaparly
payaent to the Register o Wills. Make chock
payable to "Register of W lls, Agent".
NOTE: If tax payaents ar ^ade within throe
aonths of the decedent's eta of death,
deduct a 5 percent discou t on the tax due.
Aw Inheritance Tax due w 11 becoae delinquent
nine aonths after the dot of death.
A. (~ The above intonation and tax due is correct.
Lf7 Raait payaent to th• Register of Wills with two covias of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the R gister of
~ H E C K Wills and an official assessaent will be issued by the PA Departaent of Raven e.
ONE
C
BLOCK B. ~ Tha above asset has boon or will be reported and tax paid with the Pennsylvania I heritance Tax return
ONLY to be filed by the estate representative.
C. ~ The above infona ion is incorrect and/or debts and deductions ware paid. ~,
Coaplete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to dacadant:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 ~
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions 5 -
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
IUTAL ltnLer On Line 7 or :ax ~.vmpua~~avn•
Under penalties of perjury, I declare that the facts I have raportad above are true, co rect and
tCOmplate to he best of my knowledge/.and belief. HOME C '] ('7 )
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