HomeMy WebLinkAbout11-23-10 (3)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE _
AND FILE N0. 21 -' lD -
F~, ,- ~ - TAXPAYER RESPONSE ACN 10166525
~`~`nn.''.rr ~~ ^^~F DATE 1 I - 22- 2010
eEV-)9SI EY'~FP (al.~b ) :, ft~ ~ l'
2QlQ ~ ~' ?~ ~M 12~ 55
C~~~i~ ~~
ORFw,-,n. ~ COURT
CARL D KIRBY~~~' -, .'~D C~" ~'
704 E MARBLE ST
MECHANICSBURG PA 17055
EST. OF HELEN B KIRBY
SSN 206-10-9115
DATE OF DEATH 11-06-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
NEM$ERS 1ST FCU provided the Departwent with the infonation below, which has bean used in calculating the
potential tax due. Records indicate that at the death of the above-pawed decedent, you were a joint owner/beneficiary of this account.
If you feel the inforwation is incorrect, please obtain written correction frog the financial institution, attseh a copy to this forty
and return it to the above address. This account is taxable in #eeordance with the Inheritance Tax laws of the Cowwonwealth of
Penn__sylvania. P1Qase call C717) 767-8327 ~tf-th pu~esiions. _ _ __ _ _-
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 360869 -11
Account Balance
Percent Taxable
Aaount Subject to Tax
Tax Rat•
Potential Tax Duo
PART
CHECK
ONE
BLOCK
ONLY
Date 08-24-2009
Established
$ 40,587.03
X 50.000
$ 20,293.52
X .045
S 913.21
To ensure proper credit to the account, two
eovfas of this notice wust aeeowpany
paywent to the Register of Wills. Make chock
payable to "Register of Wills, Agent".
NOTE: If tax paywents era wade within throe
sonths of the decedent's date of death,
deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will becowe delinvuent
nine wonths after the dst• of death.
A. The above inforwation and tax due is correct.
Rewit paywent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or chock box "A" and return this notice to the Rapistor of
Wills and an official essessaent will be issued by the PA Dopartwent of Revenue.
B. ~ The above asset has boon or will be reported and tax paid with the Pennsylvania Inharitanca Tax roturn
to be filed by the estate representative.
C. ~ The above info a ion is ineorr t and/or debts and deductions ware paid.
Cow
lete PART ~ a
d/
PART 3~ b
l
p n
or
e
ow.
PART If indicating a different tax rate, pleaso 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. Aaount Sub~eet to Tax 4
5. Debts and Deductions 5
6. Aaount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
Under penalties of perjury I declare that the facts I have reported above are true, c`,o~/rrect and
to o • to th best f owledge and belief . HOME C 7~7 ) ~% 6 ~ - 7".Z-
' ~ ~ d
AYER IGNATUR TELEPHONE NUM ER DA E