HomeMy WebLinkAbout12-17-10BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 - _'
HARRISBURG PA 17128-0601 _ _ _ : •,~ : - ;`
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 10-1001
ACN 10162460
DATE 11-02-2010
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** MICHAEL J PHILLIPS ~"
328 DEERFIELD RD
CAMPHILL PA 17011
EST. OF JOHN W PHILLIPS
SSN 184-24-5141
DATE OF DEATH 09-23-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
FN B BANK 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 ]oint 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 C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 007-3010576 Date 10-28-2009 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $
107
968
77 payment to the Register of Wills. Make check
.
, payable to Register of Wills, Agent
Percent Taxable X 100.00
Amount Subject to Tax $ 107
968
77 NOTE: If tax payments are made within three
,
. months of the decedent's date of death,
Tax Rate )( .045 deduct a 5 percent discounnt on the tax due.
Potential Tax Due $ 4,858
59 Any Inheritance Tax due will become delinquent
. nine months after the date of death.
P
T TAXPAYER RESPONSE
~
1
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FAILIlRE~
O RESf'OND~WIIL ~fSULI~TN~"AM fl~F
ICiAIa~,T~X
ASS~'SSMENT
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.
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
0 N E a discount or avoid interest, or check box "A" and
Wills and an official assessment will be issued by return this notice to the R~agister of
the PA Department of Revenue.
B L 0 C K
0 N L Y B.~ The above asset has been
to be filed by the estate or will be reported and tax paid with the Pennsylvania Inheritance Tax return
representative.
C. ~ The above informs ion is
Complete PART 2~ and/or incorrect and/or debts and deductions were paid.
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 i. 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 Rate 7 X
8. Tax Due 8
PART
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the bes f my knowledge and belief. HOME C ~/7 ) 975-~6~7
WORK C ?'/ ) ~~~5 ` Z7T9" /~ 20/c7
AXP ER SIGNATURE TELEPHONE NUMBER AT
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DEPARTMENT. OF REVENUE
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IUTAL ctnier on Line 5 of Tax Computation) S