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Home My WebLink About06-29-10BUREAU OF INDIVIDUAL_T~~S,~ ,_, ._ ,~~„ PO BOX 280601 ~=~~~ ' , t~~ : ' HARRISBURG PA 17128x_0601`" i l~,.tAly ~ i..• i 4~'kEV-~1543'EX-AFP (08-08) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 10-0327 ACN 10133933 DATE 06-17-2010 ~~ ~ ~ ~u~ ~ 9 ~ ~ ~ : 03 Lrfll`~L.~v~~ ~.~t~~_1~T CAROL BERGERON 410 FREEDOM DRIVE SHIPPENSBURG PA 17257 EST. OF ARTHUR W BERGERON SSN 437-70-1134 DATE OF DEATH 02-08-2010 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 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 1717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 10529355 93642 Date 04 -29 -1996 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 6 378 ~ .75 payable to "Register of Wills, Agent". Percent Taxable X 50 .000 NOTE: If tax payments are made within three Amount Subject to Tax $ is 189 .38 months of the decedent's date of death, Tax Rate ~( . 15 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 478 .41 nine months after the date of death. PART TAXPAYER RESPONSE r „ ..,.. ~~ f •.F9, .•3: ..y.• ,,.. :~? s??r,r~`:r .. ° .9i cr'r.~fe~% '<`t~ ft%° A. ~ The above information and tax due is correct. Remit vayment 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 0 N E 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 ONLY to be filed by the esta .mod ~ ~~ ~-~ ~ ...~ c o ,.--• c C' O V Yv 't"_ C. The above informs ion is incorre and/or debts and deductions were paid. ~ ~S (~1-.-~ omplete PART ~ and/or below. ~ ~ ~ ~ 1 PART If indicating a different tax rate, please state relationship to decedent: TAX RE TURN - 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 $ ;~~~'" '~',%~'.r ,~ `;fi"r .3.91'ii.'rfr/rl,. ;'»iff fli ~ ./ 9r, ?: .F .r..::, a ..p ,bY ,l,;rf. lh',r PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID C d.v r1 r ~'~ .~-- ~, ,~ a ~ ~S Zvi S TOTAL (Enter on Line 5 of Tax Computation) fi .Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best..a~ my knowledge and belief. $' ~ s a HOME C ? ~ '1 ) ~ ~- - S TAXPAYER SIGNATURE TELEPHONE NUMBER DATE 1.,~ June 28, 2010 Attn: Register of Wills ~, Ffle No. 21 10-0327 ~ ~- CAN 10133933 ~~ 6/17/2010 ~ ~ ,~,, Est. of Arthur W. Bergeron `~ ~~ ~ '~'' SS: 437-70-1134 ~- r f received this inheritance tax paperwork in regards to the checking ac ~t my deceased husband and l have had Qpen for over 13 years. Under Genral w Information, section 5, an the back of this form, accounts est~bltshed jointly between husband and wife more than one year prior to death are not taxable. l'm unclear why you would have sent me_ this tax paperwork considering Wachovia Bank would have had that information in their system. l'm enclosing the earliest bank statement I have handy on this account proving it iS an old account and not subject to inheritance tax. Please return my bank statement u-rtt~'t. your written response for rrty records. You can reach me at home in the evenings at: 717-532-5658, and from 8-4 at work at 717-545-4534. Hopefully this response wilt suffice. ft is horrible enough to lose a spouse without having to deal with all this afterwards. Thank you, L~~ Coral Bergeron 410 Freedom Drive Shippensburg, PA 17257 .~, ~~ `~~:~ c. W,~,,~ ~.~..:,~ r ~ ~..~-~ ,M; ~.~