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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF II~DIVIDIIAL TAXES AND F I L E NO. 21 10 - 018 7
Po taoc 2eocol TAXPAYER RESPONSE ACN 10120837
HARRISdUR6 PA 17128-0601
DATE 04-12-2010
a<v-is4s oc ~ cas-asp
TYPE OF ACCOUNT
EST. OF HELEN L WEIGEL ® sAViNGs
SSN 202-20-0439 ^ CHECKING
DATE OF DEATH 02-12-2010 ^ TRUST
COUNTY CUMBERLAND ~ ^ CERTIF.
REMIT PAYMENT AND FORMS T0: '~'
PATSY L WEIGEL REGISTER OF WILLS
~ ~
721 N MIDDLETON RD 1 COURTHOUSE SgUARE r^-n ~ ~
~ ~-~> , --
CARLISLE PA 17013 CARLISLE PA 17013 t=? ~ < ~~ ~~~~
r=
N --3
$
C7 C 3. .~
SOVEREIGN BANK
provided th• Departaant with the inforaation below, which has been ui in caleulati'lnp ..~
"' i
thtfi
potential tax due. Records indicate that at the death of the above-naaed daceden#, You wars a ,ioint owner/botuaticiary of 1~~ acc~ut~t
If you feel the inforastion is incorrect. please obtain written correction frog the financial institution, attach a copy td~his ion
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coaaonwealth of
Fennsylrsnia. Please call C717) 787-8827 wifih-questions.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FLLIN6 AND PAYMENT INSTRUCTIONS '~'~"'`'°'
Account No. 167406399?
Account Balance
Percent Taxable
Amount Subject to Tax
Tsx Rate
Potential Tax Duo
PART
Data 07-29-2009
Established
~ 13,008.06
X 100.00
~ 13,008.06
X .15
$ 1,951.21
To ensure proper credit to the account, two
copies of this notice aunt aacoapany
payaent to the Repistar of Wills. Make check
payable to °Repister of Wills, Apent".
NOTE: If tax payaents era aade within three
aonths of the decedent's date of death,
deduct a 5 percent discount on the tax due.
Any Inheritaeu:e Tax due will becoae delinquent
Wino aonths after the date of death.
A. ~ Tha above inforaation and tax dw is correct.
Resit vayaent to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or check box "A" snd'raturn this notice to the Register of
0 N E Wills and an official assessaent will be issued by the PA Departaent of Revenue.
BLOCK f. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 NL Y to be filed by the estate representative.
C. ~ Tha above inforaa ion is incorrect and/or debts and deductions wore paid.
Coaplete PART 2~ and/or PART 3~ below.
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 C
0
PART If indicating a different tax rate, please state
relationship to decedent:
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
Under psnslties of perjury, I declare that the facts I have reported above are true, correct and
compl• a to the_.,pbest of m~„knotrledpe and belief. HOME C 7~ 7) ~~" 2 ,~.Sy
/S.. ~ WORK C ) ~'S~ - e~~i-,S'~I/
7~7 3
TAXPA E GNATURE TELEP ONE NU B'R DATE
,u,w~ •enier on ~~ne 5 oT Tax computation)