HomeMy WebLinkAbout12-17-10 (9)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
AND
;;:_~ ~,- ,; _.,~,~ ~ TAXPAYER RESPONSE
,.
~ y i
"N6Y ~643~E7C Ak P; 'C P6-48.),_. ~
2~ ~ G GEC ! 7 P~ I ~ 2 ~
C~ EoK ~~
o~P~,~,;~e ~~1 l~~T
~, •. ,, ,
,,_~
MICHAEL J PHILL~~`P~,~F`~,-~, =~ Fy,
328 DEERFIELD RD
CAMP HILL 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.
FNB 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 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 INSTRUCTIONS
Account No. 007-3010227 Date 07-27-2009 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 5 ~ 145.1$ payment to the Register of Wills. Make check
payable to Register of Wills, Agent .
Percent Taxable X 100.00
NOTE: If tax payments are made within three
Amount Subject to Tax $ 5, 145.18 months of the decedent's date of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 231 .53 nine months after the date of death.
PART TAXPAYER RESPONSE
~ ~ ~ ~ ~ ....~~ ~ A~ „,
~~'1ILJRE~~O ~°kESPQ~D~WI~1~>t~E51~~~\ ~`~4NUFFICIIIL TAX ASSESSMENT
~'
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 ~ OFFICIAL USE ONLY ~ AAF"
relationship to decedent: ~~ ~ ~~`~
~ PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS `PAD
LINE i. Date Established 1 1
2. Account Balance 2 $ 2 ,x
3. Percent Taxable 3 X ~ 3 '°~~
4. Amount Subject to Tax 4 $ C{ `
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ ~
X
7. Tax Rate 7 7
8. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, co~rrelct~ and
complete to ~the/fbest of my knowledge and belief. HOME C r~ ) ~~~ "~sQ.~
CC~~Et+¢l~ ~~ WO R K C 7< ?) ~~~ r''~Jj9 ~ J ZF~ lQ
.X PAYER SIGNATU E TELEPHONE NUMBER A
TAX
FILE N0. 21 10-1001
ACN 10162468
DATE 11-02-2010
TOTAL CEnter on Line 5 of Tax Computation) S