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Home My WebLink About12-13-10 (4)PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po sox 2so6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (08-OB) DARREL W BENDER 1562 LOWELL LN NEW CUMBERLAND PA 17070-2239 FILE N0. 21 10-0991 ACN 10159246 DATE 10-19-2010 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 CERTTF. 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 point 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 X7)7) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005005168956 Date 09-15-2008 To ensure proper credit to the account, two Established copies of this notice must accompany $ 3 5 3. 3 6 payment to the Register of Wills. Make check Account Balance 182 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 91 ~ 176.68 months of the decedent's date of death, Tax Rate )( . 045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 4 ~ 102.95 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILURE TO RE5Pt3FID WILL RESULT IN AN OFFICIAL TAX ASSfSSMENJ 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 information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART IJ below. PART If indicating a different tax rate, please state OFFICIAL USE DWLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD *~-~ ems.. _ _ , . __,...._, LINE 1. Date Established 1 1 ["} ..... ~... 2. Account Balance 2 $ Z ~ t~ ? i ~~~ 3. Percent Taxable 3 X 3 ~ m '-' ~ ''-~"j 4. Amount Subject to Tax 4 $ 4 ~'~ f""" ..-- ,--: -~~ 5. Debts and Deductions 5 - 5 ~~Ij=~ `~f ~-` 6. Amount Taxable 6 $ 6 :.-~~-~,~ 'Z? .' 7. Tax Rate 7 X 7 `s-~ '"~ 8. Tax Due 8 ~` 8 *, ~" PART DEBTS AND DEDUCTIONS CLAIMED a G,? w 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID der penalties of perjury, I declare that the facts I c~m lete to the est of my knowledge and belief . have reported above HOME C '7~ ~ are ) true, ~ ~ correct and ~ ~'~~~ TAXPAYER SIGNATURE TELEPHONE NUMBER T --ice- DA IVIAL (Enter on Line 5 of Tax Computation) $