HomeMy WebLinkAbout12-13-10 (3)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
Po Box zao6ol TAXPAYER RESPONSE
HARRISBURG PA 17128-0601
REV-1543 EX AFP (OB-OB)
FILE: NO. 21 10-0991
ACN 10159245
DATE: 10-19-2010
DARREL W BENDER
1b52 LOWELL LN
NEW CUMBERLAND PA 17070-2239
EST. OF EMILY E BENDER
SSN 300-22-7997
DATE OF DEATH 09-10-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUI:TIONS
Account No. 000005004057031 Date 09-17-2008
To ensure proper credit too the account, two
Established copies of this notice must accompany
Account Balance $ 9, 373.91 payment to the Register o•F Wills. Make check
payable to "Register of Wills„ Agent".
Percent Taxable )( 50.000
Amount Subject to Tax $ 4, 686.96 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 210.91 Any Inheritance Tax due wiill become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
FALLURE Tfl RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENfi
A. ^ The above information and tax due is correct.
Remit 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 Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state ^
a relationship to decedent: OFFICI L USE D A
...... ~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD PA DEPART ~' OF R~ENU~:;~.-~
~ ~ C~ ~
LINE 1. Date Established 1 1 n ffti -•-9
2. Account Balance 2 $ r'T'1 -- s ~f
2 - ~.._._~_._.f '~ _.3
3. Percent Taxable 3 X „-;-4~~ _
3 - i- -~ ._
4. Amount Subject to Tax 4 $ 4 c.>~,,,)~ '"~ _.{,i
5. Debts and Deductions 5 - rJ~ ',a•'
5 ;--z-~i
6. Amount Taxable 6 $ 6 ~----{ •• `,~ ~
7. Tax Rate 7 X ' '~
7 W
8. Tax Due g $ ~
Under penalties of perjury, I declare that the facts I have reported above are true, correct and ~ 1
com ete to the best of my knowledge and belief.
HOME C~~ ) ~7"7 _ 7 -'
WORK C ) ~7f ~, ~ / ' ~ ,
TA YER SIGNATURE TELEPH NUMBER ~
DA E
raRT DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE nF4CRTPTTf1A1 _..~...._ _ _ __