HomeMy WebLinkAbout09-20-10PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE r~
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 - ~U- ~q(p U
PO BOX 288601 ,n; *~.-~, ~••-- AXPAYER RESPONSE ACN 10152342
WIRRISBUR6 PA 17128-06 01 ~ ~J~^~-~~
aevtsas ez eFF•.I~evs),, ~~ ~,r~~1f DATE 09-17-2010
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2~~a SEP 20 PM
CLERK 0
ORPHAN'S G ~~ JRT
CUMBER~NF.' . '' . i
MIDDLETOWN PA 17057-2256
MARY A CLOUSER
230 E WATER ST
EST. OF KENNETH L CLOUSER
SSN 300-32-2387
DATE OF DEATH 04-11-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
WACHOVIA BK NA provided the Department with the information below, which has bean used in ealeulatine the
potential tax due. Records indicate that at the death of the above-named decadent, You ware a point owner/benef ieiery of this account.
If You feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this forty
and return it to the above atldress. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717) 787-6527 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
account No. 1010017081205 Date 02-03-2000
Account Balanco
Percent Taxable
Amount Sub~eet to Tax
Tax Rate
Potential Taz Due
a
Established
$ 3,725.46
X 50.000
$ 1,862.73
X .15
$ 279.41
u.-a greyer Craeli Lo LlIQ aCCOwfIL, Cw0
copies of this notice must accowpany
pavwant to the Register of Wills. Make check
payahle to "Register of Wills, Agent".
NOTE: If tax payments are made within thra•
months of the decedent's date of death,
deduct a 5 percent discount on the tax due.
Aw Inheritance Tax due will become delinquent
nine months after the data of death.
A. ~ The sbova information and tax du• is correct.
Remit payment to th• Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid into rest, or cheek box "A" and return this notice to the Register of
ONE Wills and an off ieial assessment will he issued by the PA Department of Revenue.
BLOCK B. ~ The above asset has been or will be reported and tax Daid with the Pennsylvania Inheritance Tax return
ON L Y to b• filed by the estate representative.
C. The sbova informs eon is incorrect and/or debts and deductions were paitl.
v-• ComDlata PART 2~ and/or PART 3~ below.
PART If indicating a different tax r$~~Lpleasa state
Q ro lationship to decedent: V,
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balanco
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Taz Rata
8. Tax Duo
2 S
3 X
4 ~
5 -
6
7 x . oa
a s n
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Lino 5 of Tax Computation) t
Under penalties of perjury, I declare that the facts I have reportetl above are true, Correct and
complete to th• best of my knowledge and belief. HOME C 7/ ] ) 9Sf 5/-.Z,~/ ~
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TwXowvr TELEPHONE NUMBER DATE
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