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TYPE OF ACCOUNT
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~ ~7 ~"~` ~~' ~~~ EST. OF BARBARA HAHN ® savINSs
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ING
54
1063032010 ' ^ TRUST
CLERK OF DATE OF DEATH
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PHA~~~S CO,1RT COUNTY CUMBERLAND ^ CERTIF.
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Wti+tp~rl~r'L~~'~~,. ~~ REMIT PAYMENT AND FORMS T0:
SONDRA SATTAZAH N REGISTER OF WILLS
5465 BONNYRIGG CT 1 COURTHOUSE SQUARE
MECHANICSBURG PA 17050 CARLISLE PA 17013
MEMBERS 1ST FCU provided the Departaent with the infonation below, which has been used ~in calculating the
potential tax due. Records indicate that at the loath of the above-naaed decedent, you were a joint owner/benefi iary of this account.
If you foal the infonation is incorrect , please obtain written correction frog the financial institution, atta~hja copy to this forty
and return it to the above address. This account fs taxable in accordance with the Inheritance Tax laws of the'Cbmmonwealth of
Penn
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BELOW
COMPLETE
PART
1
~TIONS
REVERSE SIDE FOR FILING AND PAYMENT INSTRU
SEE
Account No. 262159-00 Date 03-26-2005 To ensure proper credit tb the account, two
Established copies of this notice aus~ accoapaFnr
Wills. Make check
payaent to the Register o
Account Balance ~
5,250.93
Dayabl• to "Registe~^ of W"lls, Agent^.
Portent Taxable X 50.000
NOTE: If tax paywents erjR wade within three
Amount Subject to Tax g 2,625.47 wonths of the decedent's ate of death,
Tax Rate X .045 deduct a 5 percent discpu t on the tax dua.
Arai Inheritance Tax dw'w 11 beeoae delinquent
Potential Tax Duo $ 118 • 15 nine aonths after the dYt of death.
PART TAJC'F'AYEN: KE,YUI7SE
A. ® Tha abova infonation and tax..-dw is corset. ',
Resit payaent to the Register of Wills with two copies of this notice to obta n
C HECK a discount or avoid interest, or check box "A" and return this notice to the R sister of
0 N E Wills and an official assassaent will be issued by the PA Departaent of Raven •.
[ BLOCK ~ 6. ^ The above asset has been or will be sported and tax paid with the Pennsylvania Ir}herftanc• Tax return
0 N L Y to be filed by the estate representative.
C. ^ The abova infor~_a~ ion is ineorr ~ct and/or debts and deductions were paid.
Cwplets PART ~ and/or PART L--J below. ~i
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Dat® 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 'f
7. Tax Rata 7 X
8. Tax Due 8
PART DEBTS AND DEDUCTIONS CLAIMED
a
Herr DeTn PeVCC i1GCCRTPTTfIN AM(111NT PATTI
TOTAL CEnter on Line 5 of Tax Computation) i i 3
Under penalties of perjury, I declare that the facts I Nava reported above era true, co
comple o ha best of my knowledge and belief. HOME (-11 ) 7 -O rect and
.S
WORK C7J ~ ~T~ -~ D
TAXPAYER SI ATURE TELEPHONE NUMBER
I ATE
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 - ~~' 0 <<R°
BUREAU OF INDIVIDUAL TAXES ~~,;r ~ ~-,~--- .
PO BOX 280601 ~- ~~~AYER RESPONSE ACN 10170018
HARRISBURG PA 17128-0601 ~`~,~ ' -, ~,
DATE 12-13-2010
REY-1563 E% IIFP (R6-RR) `~ ~ ' ' (--~.~',/