HomeMy WebLinkAbout12-17-10 (3)BUREAU OF INDIVIDUAL .TA.~E$-~, ,-•.r-:~
PO BOX 280601 - ;~ ~ _ ,'~i;
HARRISBURG PA 17128=p401_1.. ,:
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE ND. 21 10-1001
ACN 10162462
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 SAUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
a SAVINGS
CHECKING
TRUST
CERTIF.
FNB B NAK 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 (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 3000-25486 Date 06-05-2006 To ensure Proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance $ 106 ~ 988.91 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments arse made within three
Amount Subject to Tax $ 17 ~ 831.84 months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due wall become delinquent
Potential Tax Due ~` 802.43 nine months after the date of death.
PART TAXPAYER RESPONSE
.. .
1'~ DESPOND WILL~JZESULTIN A•N OFFICIAL ;TAX ASSESSMENT
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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 a discount or avoid interest, or check box "A" and return this notice to the Reegister of
Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
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~ andlor PART 3LJ below.
PART If indicating a different tax rate, please state ~ ~~~~°~• "`~fl~~~~iAL US~'\fl~LY ~ AAF
relationship to decedent:
~~~~ PA DEPARTMENT OF REVENllE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
a
LINE 1. late Established 1 1
\-
2. Account Balance 2 $ 2 ~~"
.\~~ ~. e
3. Percent Taxable 3 X 3
~~
4. Amount Subject to Tax 4 $ ~' a 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 '~ 6
7. Tax Rate 7 X ? 7
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, correct and
complete to the best of my~ knowledge and belief. HOME C 1~ 7 ) J 7J ~'./~
TAXPA R SIGNATURE TELEPHONE NUMBER DAT
TOTAL CEnter on Line 5 of Tax Computation) $