HomeMy WebLinkAbout07-08-10 (7)BUREAU OF INDIVIDUAL TAXES
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
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LEONA FICKEL
124 OLD FORD DR
CAMP HILL PA 17011-8352
EST. OF GILBERT K SHIRK
SSN 179-09-9036
DATE OF DEATH 01-08-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
® CERTIF.
FIRST NH OF PENNSYLVANIA provided the Devarteent with the inforeation below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-Hawed decedent, you were a joint owner/beneficiary of this account.
If you feel the inforeation is incorrect, Dlease obtain written correction frog the financial institution, attach a copy to this fora
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coeeonwealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 101040816 Date 07-22 -2008
To ensure proper credit to the account, two
Established copies of this notice Bust accoeparry
payeent to the Register of Wills. Make check
Account Balanea 10,313. 55 Davable to "Ragistar of Wills, Agent".
Percent Taxable X 16. 667
NDTE~ If tax pageants are ^ade within three
AeOUnt Subject to Tax $ 1 , 718. 96 months of the decedent's date of death,
TaX Rate X . 045 deduct a 5 percent di§count on the tax due.
Any Inheritance Tax due will becoee delinquent
Potential Tax Due
s.e~ -. ~ 77.35
Tavwav~w r-:r.wwwuw~ nine eonths after the data of death.
A. ~ The above inforeation and tax due is correct.
Resit pageant to the Ragistar 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
C ONE ~ Wills and an official assesseent will be issued by the PA Departeent of Revenue.
BLOCK B. ~he above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY o be filed by the estate representative.
C. ~ The above inforea ion is incorrect and/or debts and deductions ware paid.
Coeplete PART 2~ and/or PART 3~ below.
PART If indicating a dlfferent tax rate, please state
relationship to decedent: ~~/ :' 1 ;~< ; ~+'
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~` ~ ~ µ"•' ~ 'f~ '' ~ ~
~ 5,. t
LINE 1. Date Established 1 .. ,~, ~,~
2. Account Balance 2 ~ ~ w ~ ,`~ ~""
3. Percent Taxable 3 X !~, `_
4. Amount Subject to Tax 4 ~ 1j ~,.' »# ~ °+ ~,k ""~ `
5. Debts and Deductions 5 ~ ,,,~,,,,~„,,;,,,,~;; ` ' '~` ~`
6. Aeount Taxable 6 ~ ,~ ~°~~•
7. Tax Rate 7 X
8. Tax Due 8 +~
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
Under penaltles of perjury, I declare that the facts I have reported above are true, correct and
Coeplete to theme b~jest of my knowledge and belief . HOME C 7/J ) ']3 7 ~ a /U 7
~-Q-csY~~r.. }1t ~.t~E~ WORK ; ~ D Al ~ (2 ~~ fi •) O
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
FILE N0. 21 10-0344
ACN 10132196
DATE 06-09-2010