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HomeMy WebLinkAbout09-01-10 (5)6UREAU OF INDIVIDUAL TAXES Po cox zaosol HARRISBURG PA 17128-0601 ~.w'~c7 r`~x'".FP ~~tM~i. PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND i~r TAXPAYER RESPONSE FILE N0. 21 10-0044 ACN 10136795 DATE 06-30-2010 ZQ 10 SEP - i PM 3~ 5 ~ CLERK ~F ORP}-iAf~J'S c©URT ANDREW H VANSCYOC 11b09 GALT AVE SILVER SPRING MD 20902 TYPE OF ACCOUNT ^ snvlNCs ^ CHECKING ^ TRUST © CERTIF. EST. OF JOHN M VANSCYOC SSN '211-36-9776 DATE OF DEATH 01-07-2010', COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS ~, 1 COURTHOUSE SQUARE CARLISLE PA 17013 PSECU provided the Department with the infonation below, which has been used potential tax due. Records indicate that at the death of the above-need decedent,` you were a point owner/benef9 If you feel the information is incorrect, please obtain written correction frog the financial institution, attael and return it to the above address. This account is taxable in accordance with the Inheritance Tsx laws of tM I .. PeawraElviuia.. Piage pll Hie) 7i7-1327 °~riZh ~testions. - COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRU calculating the ry of this account. copy to this fora onweallh of . IONS account No. 0211369776IRA63 Date 02-08-1989 Established Account Balance s 2 ~ 018.86 Percent Taxable X 16.667 Amount Subject to Tax ~ 336.4$ Tax Rate X .045 Potential Tax Due ~ 15.14 PART a To ensure proper credit tolth• account, two copies of this notice must) accompany payment to the Register of~Wills. Make check payable to "Register of Wi ls, Agent°. NOTE: If tax payments are'mada within three months of the decedent's d to of death. deduct a 5 percent discoun on the tax due. Arne Inheritance Tax due wi 1 become delinquent nine months after the date of death. A. ~ The above infonation and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or chock box "A" and return this notice to the Re ister of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue BLOCK ~ B. ^ The above asset has bean or will be reported and tax Daid with the Pennsylvania Inheritance Tax return 0 NL Y to bo filed by the estate representative. C. ^ The above infona ion is incorrect and/or debts and deductions ware paid. Complete PART ~2 and/or PART 3^ below. PART If indicating a different tax rate, please state relationship to decadent: 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 g $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TDTAL CEnter on Line 5 of Tax Computation) ! Under penalties of perjury, I declare that the facts I have reported above are true, cor complete to the best of my knowledge and belief. HOME C.?n / ) `3U~. L ~ 1 r _ ~ .,, .:._ ....~ TAXI t and !/~.,/ ~~~U - WORK C ~O~ 1 TA/ TAXPAYER SIGNAT TELEPHONE NUMBER