HomeMy WebLinkAbout03-09-11PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
FILE N0. 21 10-D345
BUREAU OE INDIYIDUAL TAXES rj ,,'~~ ~~ ~L~~ ~ND ACN 11114918
Po Box zaosol R ~ , td~(~~-{r~R RESPONSE
WIRRISBURG PA 1 7128-06 01 ~.. ~~ I ~ DATE 03-04-2011
REV-3563 EY 1FP lER RRl
'•"` ~ ~{~~ -~ `'1'~ ~c ~ E~T. OF DIMITRI ANDRIUTSA
SSN 058-30-7400
CLERK GF DATE OF DEATH 03-05-2010
ORPNA.N`S COURThhnCOUNTY CUMBERLAND
CUMRE~;I ,~! ~~.; v~~ , rA¢EMIT PAYMENT AND FORMS T0:
PAULINE ANDRIUTSA REGISTER OF WILLS
4905 E TRINDLE RD OFC C 1 COURTHOUSE SRUARE
MECHANICSBURG PA 17050-3643 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
O TRUST
CERTIF.
CITIZENS BANK OF PENNSYLVANIA provided the Department with the information below, which has been used in calculating the
Dotantial tax due. Records indicate that at the death of the above-nammd decedent, You were a joint owner/beneficiary of this account.
If you feel the inf ormatian is incorreetr Please obtain written correction from the financial institution, attach a copy to this fora
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowmonwealth of
Pennsvlvania. Please call (717) 787-9327 with questions.
- .......,, r~r t1wOT , YCI nW x CFF aFVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6225343796 Date 06-25-2009 To ensure proper credit to the account, two
copies of this notice oust accompanv
Established payment to the Register of Wills. Make check
Account Balance $ 87, 111.54 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 43,555.77 months of the decedent's date of death,
1 5 deduct a 5 percent discount on the tax due.
Tax Rate X Any Inheritance Tax due will becowe delinquent
Potential Tax Due $ 6,533.37 nine months after the date of death.
TAXPAYER RESPONSE
PART
A. ^ Tha above information and tax due is correctR.
Remit payment to the Regi star of Wills with two copies of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be-issued by 'the PA Department of Revenue.
C ONE
BLOC K B. ~ Tha above asset has been or will be reported and tax Paid with the Pennsvlvania Inheritance Tax return
ONLY `A-~//k_q be filed by the estate representative.
C. ~\, The above informs Son is incorrect and/or debts and tleductions were paid.
"`TTT Complete PART 2~ and/or PART 3^ below.
PART If indicating a different t ,r plc se state
relationship to decedent: ~~ ~JrP
TAX RETURN - COMPUTATION OF T,/!X ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 "~~~'7'~,0~
2. Account Balance 2 ~T ~
3. Percent Taxable 3 X'
4. Amount Subject to Tax 4 $ ~a
5. Debts and Deductions 5 - ~ '
6. Amount Taxable 6 '~
7. Tax Rate T X -~
8. Tax Due 8 $ ~ ~ .
PART DEBTS AND DEDUCTIONS CLAIMED
^3
nwrr owrn PAVFF DESCRIPTION AMOUNT PAID
Under penalties of perjury, I de re~that the facts I have reported above are true, correct and
complete to th
~g9'r9f ledge and belief. HOME c 717 ,SrJ`7-x/957
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