HomeMy WebLinkAbout02-08-11PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~~Q~~O
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 " '
PD cox zaoaol ~ ~~~~ ~'C~YER RESPONSE ACN 11102848
FIARRISBURG PA 171za-0801 1r~~(~{{r~~. -. a•-(j'?~ J C DATE 01-17 -2011
REY-1543 E% AFB (09-1~~ i ~' ' ~/r i~p~~~tJ
Z~~f ~~~ _$ a~ ~t~ ~~ EST. OF BURTON W MCINTIRE
SSN 213-38-0563
(;~(~( QF DATE OF DEATH 01-02-2011
~~ygq~~ ' COUNTY CUMBERLAND
NllM D C DA REMIT PAYMENT AND FORMS T0:
BOPHA T MCINTIRE Q alt REGISTER OF WILLS
1139 COUNTRY CLUB ROAD 1 CDURTHOUSE SQUARE
CAMP HILL PA 17011 CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU provided the Dapartaent with the inforaation below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-naaed decedent, you were a ioint owner/beneficiary of this account.
If You feel the inforaation is incorrect, please obtain written correction frog the flnaneial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Loaonweelth of
Pennsylvania. Please call (717)_3@7-827 with q[nlstions. - - ~ - - -
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 198556-0 0 Data 11-08-2000 To ensure proper credit to the account, two
Established copies of this notice suet accoaparry
pageant to the Repistar of Wills. Make cheek
Account Balance $ 3 9 2.6 7 payable to "Repistar of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax Dayaents era aade within three
Amount Subject to TeX $ 6 5 .45 aonths of the decedent's dat• of death,
X 0 0 deduct a 5 oereent discount on the tax due.
Tax Rate , Arty Inheritance Tax due will becoae delinquent
Potential Tax Duo $ • 0 0 nine aonths after the data of death.
PART TAXPAYER RESPONSE
0
A. ICI The above inforaation end tax due is correct.
L~`~ Resit pavaenL 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
Wills and an off ieial assessaent will ba issuetl by the PA Deoartwent of Revenue.
C ONE
BLOCK B. ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY to be filed by the estate representative.
C. ~ Tha above inf orae ion is incorr ct and/or debts and detluctions were paid.
Coaplete PART ~2 and/or PART ~ below.
PART
TAX
LINE
If indicating a different tax rate, please state
relationship to decedent:
RETURN - COMPUTATION
1.-Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Taz Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 ~
3 X
4 S
5
6 S
7 X
8 $
PART DEBTS AND DEDUCTIONS CLAIMED
a
Under penalties of perjury, I declaro that th• facts I have reported abovge are~7true, corre~tnand
complete to the bast of ,mfr kno~rledge and belief. HOME Cam] ~ I ) • ~ ~ ~~i
WORK C~17 13 2~ ~'~'~~
TELEPHONE NUMBER DATE
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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