HomeMy WebLinkAbout01-27-11BUREAU OF INDIVIDUAL TAXES
PO BOX 200601
HARRISBURG PA 17128-0601
SEY-I5iS EY
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 ' ~ ~'- }
~r.f_ ,~f~T~AXPAYER RESPONSE ACN 10143452
ur DATE 07-30-2010
b)
;~i`! 1 ~ ~~! 27 ~1°°~ i i ~ 32
CLERK 0
ORPi1APJ'S CC)IJRT
ANGELA K RILEY CUP~E3~ ~~'~tiL %O, PA
1007 VILLA GRAN WAY
FENTON MO 63026
EST. OF SHIRLEY K LATIN
SSN 188-32-3180
DATE OF DEATH 07-14-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU provided the Department with the information below, which has been used in calculating the
votantiel tax tlue. Records indicate that at the death of the above-nomad decedent, you were a ioint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, attach a cony to this form
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Co~~onwaalth of
Pennrilvania. Please call C717) 787-8327 with Questions. ~~ - -
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 226404-00 Date 01-30-2003
To ensure proper credit to the account, two
Established copies of this notice wust accompany
Account Balance s 2,830.73 oriment to the Raei star of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax g 1,415.37 NOTE: If tax payments era made within three
months of the tlecedent's tlat• of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 63.69 A'ar Inheritance Tax due will become dalinauent
nine months after the tlate of death.
PaT TAXPAYER RESPONSE
1
A. ~ The above information and tax due is correct.
Remit payment to the Register of W311s 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
ONE Wills and an official assessment will be issued by the PA Department of Revenue.
BLOCK ~ g, ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONL Y to be filed by the estate representative.
C. ~/fh• above info a ion is incorrect antl/or debts and deductions were paid.
`L7(~Complate PART ~2 and/or PART 3~ below.
PART If in dicatiny a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX
' ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 i '.~n~ ~3
2. Account Balance 2 s as30-'~ ~
3. Portent Taxable 3 X p. 0
4. Amount Subject to Tax 4 ~ 1 1-! J 5. 3
5. Debts and Deductions
5
/ _
y 1~,3
6. Amount Taxable 6_ _$ ~
7. Tax Rate 7 X
8. Tax Dua B $ (~
PART
0 DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRrPrrnu .....,,.,r ..
u ZZ . r e ~ ~ / .
TI.T ~ ,
- -- '- ~ .., yaw wmpucaclon~ i
no r penalti # of p jury, ecla re that the facts I have reported above era truen~c-orre~t and
om ate to t best of my wl dga and belief. HOME C ~O ) ~0~~'a{y.+
~ WORK ( 3l ) $~- 137 / 2311
TA AVER SIGNATUR TELEPHONE NUMBER ATE
q,a
i;
Y, ~ ..:
'"
A
n,`t t^y ~'
w~
T
f-`;
x.~
~:
i2
~-
s
~
~
°.`_'I
i ~~ ,,~ff
Y•5
~
'!~ _
~
ti
r,g ~ (~ (=
~ ~ ~
~ o ,.
_
~
~ ~
~•n
ti~
~~