HomeMy WebLinkAbout10-26-10PENNSYLVANre Tu~~~..._..__
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 ;~ ~ -
HARRISBURG PA 17128-0601
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REV-1543 EX AFP ('08=08)
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~* THOMAS E KECK
2100 BENT CREEK BLVD
STE 137
MECHANICSBURG PA 17050-1832
INFORMATIONnNOTICECE TAX
AND
TAXPAYER RESPONSE
F I LiE N 0(121 (, L~~ :-
ACN 10159553
DATE 10-21-2010
EST, OF
HILDA R KECK TYPE OF ACCOUNT
SSN 168-26-3436 ^ SAVINGS
DATE OF
COU DEATH 0 3 -15 - 2010 ~ CHECKING
^ TRU
NTY
REMIT CUMBERLAND ST
^ CERT
PAYM ENT AND FORMS T0: IF.
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
SOVEREIGN BANK
potential tax due. Records indicate that pat thee death of the aboveltnamed deced nt ion below
If you feel the information is incorrect, please obtain written correction from the fi ~ which has been used in calculating the
and return it to the above address. ~ you were a joint owner/benefic:iary of this account.
°ernsylvanis. P This account is taxable in accordance with the InheritancenTaxtlawsnof the Commonwea
le°s2 cell (.'171 787-83^~ attach a copy to this form
COMPLETE PART 1 BELOW *~ w~~r ~"estions.
SEE REVERSE SIDE FOR FILING 1th of
Account No. 1991022174 AND PAYMENT INSTRUCTIONS
Date 07-16-2009
Established To ensure proper credit to the account,
Account Balance copies of this notice must accompany two
Percent Taxable '~ 28, 436.0$ payment to the Register of Wills.
~( payable to "Register of Wills, Agentake check
Amount Subject to Tax 50.000
Tax Rate $ 14 ~ 21 $ , 04 NOTE: If tax payments are made within three
~( months of the decedent's date of death,
Potential Tax Due 00 deduct a 5 percent discount on the tax due.
PART $ 00 Any Inheritance Tax due wil:i become delinquent
a nine months after the date of death.
TAXPAYER RESPONSE
AILU~R°E TO RESPOND WILL RESULT IN AN OFFICIAL TAX AS
A• The above information and tax due is correct. SESSMENT'
Remit payment to the Register of Wills with two copies of this notice to obt "
C H E C K a discount or avoid interest, or check box "A"
0 N E Wills and an official assessment will be issued b gin
and return this notice to the Register of
BLOCK v the PA Department of Revenue.
0 N L Y B' ~ The above asset has been or will be reported and tax
to be filed by the estate representative. paid with the Pennsylvania Inheritance Tax return
C• ~ The above infor,m~~a ion is incorrect and/or debts and deductions we
Complete PART ~2~ and/or PART ~ below.
~u- ~--~ re paid .
PART If indicating ~ a; « __
~,,~ - ~ -- ~~~~erenI tax rate, please state
u relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACC
LINE 1. Date Established OUNTS PAD
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 ~ X
8. Tax Due $ $
PART
DATE PAID PAYEE
OFFICIAL USE ONLY
PA DEPARTMENT OF REVEN~ AAF
i
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
Under pena'I t;
TOTAL (Enter on Line 5 of Tax r.,~,,..,~_~.
AMOUNT PAID
--- --~ )+crJUrY, I declare that -.--_~~yV~~~ $ -
complete to the best of m the facts I have reported above are true
y knowledge and belief. correct and
'' ., ~.,, -..y ~° /-;.~'~ HOME ( ~ L.
TAXPAYER SIGNATURE V ''--_
WORK ( ~
TELEPHONE NUMBER -- ~ ~
DA E ,