HomeMy WebLinkAbout09-20-10BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
I _ .. _i' I... _ ., ~.
~.y, _.
w L~l"TI` 1(643 ~E)( AFP (~A -OB )'
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE
~~ TAXPAYER RESPONSE ACN
DATE
N0. 21 10-0192
10149828
09-Ob-2010
za~a sEP Zo ~~ ~. ~~
pp{ry~CEpp.E,~RK ~~ p7'
C~f~.~.~:_ j_ ~~ ~.
CARL A DICKSON
3b02 N THIRD ST
HARRISBURG PA 17110-1506
EST. OF JAMES A DICKSON
$SN 174-20-3225
DATE OF DEATH 12-02-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
^ savlNGs
® CHECKING
^ TRUST
^ CERTIF.
PNC BANK NA provided the Department with the informatio
potential tax due. Records indicate that at the death of the
b
- n below, which has been used in calculating the
a
ove
pawed decedent, you were a joint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction frow th
fi
e
nancial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with th
e I
Pennsylvania. Please call (71.7) 767-6327 with questions. nheritance Tax laws of the Commonwealth of
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005004894067 Date 11-20-2006
To ensure proper credit to the account
two
Established ,
copies of this notice must accowpany
Account Balance $ 2, 919.80 payment to the Register of Wills. Make check
Percent Taxable X 50.000 payable to "Register of Wills, Agent".
Amount Subject to Tax $ 1,459.90 N07E: If tax payments are wade within three
Tax Rate X months of the decedent's date of death,
.045 deduct a 5 percent discount an the tax due.
Potential Tax Due $ b5.70 Any Inheritance Tax due will become delinquent
nine wonths after the date of death.
PART TAXPAYER RESPONSE
A. ^ The above information and tax due is correct.
Rewit payment to the Register of Wills with two copies of this notice to obtain
C H E C K 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
0 N L Y to be filed by the estate representative. Inheritance Tax return
C. The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ^f2 and/or PART 3^ below.
rAKI Lr inaicating a olfferent tax rate, please state
relationship to decedent:
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 $
PAD
1
Z
3
4
5
6
7
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) ¢
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to thg best of my knowledge and belief.
((((l/ylj/l _ HOME c 7/ ) ) L;;~ G~'~
WORK c ~i ~ ) Sgk 5i f~ x Ll ~( 4 -~C
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
OFFICIAL USEONLY ~AA~
PA DEPARTMENT OF ~E~/EN1#E
a
U5A 'FlRST-C4A54 FOREVER
.~
,a .,~.
~
~
~
~ ~
.
~, ' ~ y 2010 SEP 20 PM 4~ 02
Q
:~,~
3
1
~
~ ;
~
~ ARK a~
~
t ~
.~ .'~': ~ pRPHAN'S ~Ot)RT
4iY°S ' t
i
0~ : M">
/i.
{' !~M1
N
~':
rR i
ti
p',
:t: ~~
'~_.F
~
M
.. },
.. ~,:
'ai r. J
l~«-
'
Yw
'n.
'.. j ,t`j
=
i
.. ~~
~~ ~ 3
~ a
o
{
~ ° ~_ ['i
'ter L~
~~,,~ ~
~'~ fa j
[5}
! ~
~
Q
.j..}