HomeMy WebLinkAbout10-28-10 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AN D
PO BOX 280601 ~,;. ,(-~i Ar ~~ TAXPAYER RESPONSE
HARRISBURG PA 17128-0601 ~-; ~ ~ ~ u ~. u:
REy:1S43~,E% AFp.(1!ti%8,~k.~':~ I
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CLERK of
o~Pt-~v~s oou~j
FAYE L HAIN--MgERLA~~C~ CO . PP.
10 CIRCLE DR
CARLISLE PA 17015
FILE N0. 21 10-0896
ACN 10159838
DATE 10-22-2010
EST. OF RUTH A LONG
SSN 197-40-6546
DATE OF DEATH 07-29-201'0
COUNTY, CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS ',
1 COURTHOUSE SQUARE
CARLISLE PA 17013
To ensuro proper credit
copies of this noticr ^
payment to the Register
payable to "Register of
SOVEREIGN BANK provided the Department with the information below, which has boon usedin calculating th•
potential tax due. Records indicate that at the death of the above-named decedent, you ware a ioint awnar/benefi iary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, atta~ChIa copy to this form
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of theLCboonwealth of
Ponnsylvania. Please call C717) 7a7-8327 wi#h gwstions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1675292005
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
Date 08-29-2001
Established
g 10,011.01
X 50.000
$ 5xOQ5.51
X .045
$ 225.25
NOTE: If tax payments a
months of the decedent's
deduct a 5 percent disco
Arty Inheritance Tax dur,
nine months after the dp
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
® CERTIF.
the account, two
accompany
Wills. Make check
ls, Agent".
aade within three
t• of death,
on the tax due.
1 become delinquent
of death.
A. ~ The above information and tax due is correct.
Resit payment to the Register of Wflls with two copies of this notice to obta~n
CHECK a discount or avoid interest, ar check box "A" and return this notice to the R gister of
C ONE ~ Wills and an official assessment will be issued by the PA Department of Ravan(~a.
BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Ir{Mritanca Tax return
0 N L Y to be filed by the estate representative.
C. ~ Tho above informs ion is incorrect and/or debts and deductions were paid. !i
Complete PART 2~ and/or PART 3^ below.
PART If indicating a different 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 Rat• 7 X
8. Tax Due 8 ~
PaRT DEBTS AND DEDUCTIONS CLAIMED
3^
nATC PATH PAVCC TCCr`DTDTTl1Y AYf111YT DATA
TOTAL CEnter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above are true, c¢rl
comp to to the best of my knowledge and belief. HOME C ) rect and dd
~ D~~v'
WORK C )
TAXPAY SIGNA URE TELEPHONE NUMBER DATE
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