HomeMy WebLinkAbout03-04-11 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
Po Box 280601 TAXPAYER RESPONSE
HARRISBURG PA 17128-0601
REV-1543 EX AFP (OB-OB)
FILE N0. 21 10-1215
ACN 11109785
DATE 02-15-2011
JAMES T TREGO
733 FLORENCE CIRCLE
MECHANICSBURG PA 17050
EST. OF ELIZABETH T TREGO
SSN 162-22-6013
DATE OF DEATH 12-04-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
ORRST OWN 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 point 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. 4000028930 Date 09-24-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 109.95 payment to the Register of Wills. Make check
1 0 0 ~ payable to "Register of Wills, Agent".
Percent Taxable X 100.00
NOTE: If tax payments are made within three
Amount Subject to Tax $` 100 ~ 109.95 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 $ 4,504.95 nine months after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK 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 tiled by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3~ below.
PART If indicating a different tax rate, please state .~~~
relationship to decedent: \\\\~ \ \
~~ ,
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS p\~ ~ ~~~ ~~
.. ~~\
LINE 1. 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 $ 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, correct and
complete to the best of my knowledge and belief. 7 ~ ~_
~_ _..------ H O M E ( 71
,r,~~t~C~ WO R K ( ) Z Z 3 1I
7f'PAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) S