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HomeMy WebLinkAbout12-30-10PENNSYLVANIA INHERITANCE INFORMATION NOTICE BUREAU OF INDIVIDIYIL TAXES ~[ t1[ AN D Po Box zsoeol } TAXPAYER RESPONSE HARRISBURG PA 17128-0601 f~f ( (1 REV-1543 EX AFP cee-ee~ e TAXI FILE N0. 21 =old '`2 p" ACN 10173147 DATE 12-20-2010 ~~{~ ~E~ 30 ~~ (L~ ~~ a.~c of C,l1MSERLAND CQ., FA: BONNIE L HOOVER 42 VICTORIA WAY CAMPHILL PA 17011-1732 EST. OF HERBERT L CASE SSN 166-05-1541 DATE OF DEATH 11-10-201Q COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE j CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has been use in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/bene igiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, akta h,a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of khe Commonwealth of Pennsylvania. Please cal l_ C717) 787-8327 ,with questions. _ ~ -- COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INS'~R ~TIONS Account No. 000005140009763 Date 01-01-1978 Established Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due $ 547.47 X 16.667 $ 91.25 X .045 $ 4.11 To ensure proper creditt0 the account, two copies of this notice ^~s4 accompany payment to the Ragisterlof Wills. Make check payable to "Register of~IWills, Agent". NOTE: If tax payments rq made within three months of the decadent' date of death, deduct a 5 percent disc u¢t on the tax due. Any Inheritance Tax due will become delinquent nine months after tho d t~ of death. PaT TAXPAYER RESPONSE 1 A. ~ The above intonation and tax due is correct. Remit paprunt to thv Register of Wills with•two copies of this notice to pbt i8 CHECK a discount or avoid interest, or chock box "A" and return this notice to 4he R$pister of C 0 N E ~ Wills and an official assessment will be issued by the PA Departmont of Rave u~. BLOCK B. ~ Tha above asset has been ar will be reported and tax paid with the Pennsylvania inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ Tha above inform ion is incorrect and/or debts and deductions ware paid. Complete PART 2~ and/or PART ~ below. 'i PART If indicating a different tax rate, please state relationship to decedent: TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS tINE Z". Date -EstaZil3shed ~ 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION ~~, AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) ~,t Under penalties of perjury, I declare that the facts I have reported above are true, cojrrect and complete to the best of my knowledge and belief. HOME C ) _ WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER I DATE ~, .Account Transaction Detail Report Fage 1 of 1 THO~RNWALD HOME 442 Walnut Bottom Road, Carlisle, PA I7013 (717) 249-4118 • (7I7) 249-8906 FAX www.ucc-homes.org I~~ 'I ~i 15 March 2006 Re: Herbert Case DOB: 10/OM1916 SSN: 166-05-1541 To Whom It May Concer-: Please be advised that my patient is incapable of u~r-de~stsnding his rights or ' g her personal financial afi'airs due to cognitive impairments relating to his dementia. Thank you. sincerely, r.,____ Goorge P. Bransctun, M.D. Attending Physician I ~! prvgr,mx of source for tJk olda~Pusar spox~v~ed by Ux7ted CArrra~k of Clrrisit Hares I ~~ j ....'+"' `~~ ~,~ ~~~ :. ~~' ~, ~~ _ ~~~ s~ o~ ~~ Ydf7 ~ OF Ag~ZS A~°~s ~ ~~~~ ~ o ~' 4~ ~gIT ~ ~ YOR3R O~ A~PORti~Y ' ~s$ 'lam P~ 40~3g ~~ "~ ~ yI~ g$BtE I1zCAP~ ~Q~ GS~1F~ g~C~ D~]t~'_~ng ~ss~ YOB ~g~ ~~T P ~ ~~~ ~' o~ ~ F ~•r ~ ~ ^", -,~,,, , ~~ ,xs I I ~, i ~ ~ i i i i I ~~ ~~ I i1 ~I I '~~~, ~~~~~ ~~ r~'E ~~~ V~~~ ~. a~ A,c = ~ ~~ Yom' ~~3R ~~~" ~~~~ ~ ~~ ~~ ~~~ A ~~• ~~ ,g . ~~ ~ ~ ~ ~ ~$ ~~~~~ ~~ ~ ~~ }y y J~~~~r ' ~~ ` ' Y ~~ ~ ~~ ~ ~ ~.~~ ~~~~. :~ .~~~ ~ ~S Q~ Z~ ~~ y .~~~ ~~ ~ ' ,rp ~ S- ~i ~~ ~''`1 '1' ~,gt~ . 2 of ~ ~~~ ~.~-- ,~ '~ ~, ~ ~e ~ , ~r~ L . Case , Of Cumberland Pennsylvania, do ~.ereby a}~oi,nt 8 HQ+c~er , ©f C~berl sx~d Ct'~urity , F true as~-d ~.a~rful (~+es~iaaf ter rt3~@,rr~i tC 88 •rith ful3. p~oM+er of substitut~i.on, tol: in my name , to tran~~act alb: ~Y hush: to ~a~e a~.l ~Y P-=~r anc~ aff'a m~c,~ht do if }~ersonal.lg pie ent, butt not .~i:~. ted to the fc-11c~~:#~~g tie le~es~tat~ of ~i+c~ shah accardant~e with 2fl ~a . Cons . tat _ ~ ~~ _ ~o create a trust for ~€~ ma~+e adder moans tv trust fir berYeft . 3. Ta claim an ~le+etive estate. uherer~ ~ ' ~ entitled . 4.. ~a aUSclam. any gr~t~ . Ps}gg 3 f of ~ ~ ~ L ~--~ an ' e ~chsr~e ntelz~ 'aunty , ~nie L . ~lvana -fact ~gent~' aye and ass and is as ~ ~~~~ r lae in i~iQ3 ;. ~t~r in .any t in ~.~.£. ~o x~~~ recfa3~e inec~me o~ carpus of a true . ~:ael. f uv~~trlg, ruses t~a~ s~i~.~~r ~a~clt~ and exxter ir~tc~ ~ ~t~ fs~r nth esre - S _ ~c~ ~~3c~t~c~ ~a~ snd ~ca~.. ~~~ ~ . ~`c~ `sue iu reel. ~`~'' tra~acfii.a~ns es. ~t~~,, ~rt~s~°o~ ~ _~~~g~ae , lesst~r , ~@S see , F ~ s~s~ca~~s . II.. ~a ~ in a~c:k, ~~sd ~ o+e~r ~ac:i~i+~s ~csu~act.~:ous . 12. ~a er~ga~e ~~ cis: '-v~~on #.ra~ac^~a.ons . l~ . - ~ ~.~ fuauci.el ~rgct-ans 1~ ~ ~~ .~~+~~ ~as~~e~ ~~ ~ r mrargi~r, acuA~ c-r ~t~a~ 3~ . ~o safes ~Ca~ct ~r+~ I ~~f ,- ~:~:~. transactQns . 18. its d~.e i~nt~r~sts antt tr~s~s . ~. g . ~~ g~ea~rs cis ~ ~i 2t) . ~~ re~E~~ c3averz~merjt b t~~L At~'1~3~' i.n I ~stat~sr w ~~. AEI Poxer~ d~scrb~d reel ~e ex~rc.~~t ~ri~t.~i re.~geca ~~ ~~~- Mich I a~ r~~ ~rst,~r+es ~~ ~ ~ c ~~tes~.~ i+et~xer ~s TI~.~ F1~R~L ~8~.. ~ac~vpr~ 5 ~f ~. ~ s~is~..l ~t~r in ,~ i ~isur in js. gam: ~ ~.i~.~t _ M.L.C. ~~ . At~~~ ~errson ~~ ~ct~ r~e~.ce~- ~~ ~ pu~r~er ~f ~,~~~rn incur nc ili. ~s a r~st~~t+ ~cc+~r~dance ~~.#~ # .~~#,ca3.ns ~~ ~~ i~c of at~~: r~.ot~ a~ ~` €~sa~i3~ty- or i~n -~-~. ~ ~ ~e~f~e~t ~~ xis nib of ~~ ~ ~~ ~nrt its ~-~ I ~tt~s~ ~c.~"~-~ .~..+e ~i~1~7t sal :~.=x~ ~. ~~ ~~ R ~' ~~ ~~ng ^~ city 'to #.~e ~ , ~~~ ~~~, ~~taru~~,ic~ r~ tt~ his. ~n~~~nt shs3.3 b!er ~a~e f a-f ~ ~, r ~~ n :~ec3 the __ _ _ _ _ ___ __ __ ____ _ _ i ~i ~13.~$ J +- ~ i/ a.. 1. ~, ~. ~~~s'~ '~` E3 ~z`~~E ~.:~.. C . r ~~~ ~~ ~ ~~ i ,, I i r _ ~ ~3. ~~ se ~ - # 3.~" 1 ~-s~ ~`' ~ ,,II ~' ~`~` . 'I _..~..r---~' ,~~"~. _ ~ r ~~ ~ 1 ~'~~~ ''. ~~ ,_ ~~~ . -. ,. attaCred g4~er t>f at~o~z~ ~.~~. ~ serf ~e +'.~~. ~1~C -~~t# ~-x see ~c~ . ~r~+ ~* 3~~e.: ~a~e 9 ~-~ 9 ~~ l~_~._~_ '~ ~~ ~~ t~+~ l~ . _ _ .. R~G'~ ~~rY f-~~ ;~~~ 2018 SEC 301, P~# i2~ ~ $ 42 Victoria Way Camp Hill, PA 17011 December 29, 2010 Register of Wills 1 Courthouse Square Carlisle, PA 17013 T'o Wlwm It May Concern: RE: Pennsylvania Inheritance Tax I was on my parent's bank account since 2004 as a POWER OF ATTORNEY ( because neither parent was able to handle their affairs (see letter from Dr. Bran: mother is blind from Macular Degeneration). The $547.47 that was in the bank account was part of my father's $950.00 Social that he received on Nov. 3`~ (as shown on statement). When my father died on Nd $450.00 he received on the 3"~ was reclaimed by Social Security. I had to add an amount of $402.53 to the account because it was in deficit by this aznount (as shop statement). The balance of the account was actually 0. If you need additional documentation, please let me know. Sincerely, .~. ~'~ ~~~ Bonnie L. Hoover Enclosures: Power of Attorney, Bank Statement as provided by PNC, check from showing POA aad letter from George P. Branscum, M.D. ejnci©sed) a'nd my ' ty check 1 p"', the ..~. the elaccount ~~ °~ ~`, ~. ~ g `~ ° a ;; F„ ~ ~ ~d ~"~"d J i '~ l lOL L b'd II!H duae~ ~teM alaololn Zb aanooH ~ a!uuo8 saW ~~# ry ~~ ~j 4 `, ~;;~ ~+ ~ ~ r o- ~, I+'~ J r i it `•... ~--.. ~- .. ..' +,.~ ~.-.. ~~- :.. `.. ....... -.~.. w, ~~ +.. ...~ .~,. +~..