HomeMy WebLinkAbout03-11-11 (4)BUREAU OF INDIVIDWL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
REY-1 Sfi EX ~FP (RR-16)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 10-0872
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~~ TA~tPAY~'~~}ESPONSE ACN 11110551
~~~ ~ DATE 02-21-2011
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UI I rl,~f~ ~ ~ /I'"I ~7l.p~jOF GUST LEE
SSN 172-18-1751
CLERK rF DATE OF DEATH o8-05-2010
ORPH.nn~'S ~Q~~oUNTY CUMBERLAND
CUhq~rr~L,h~JD ~,Q REMIT PAYMENT AND FORMS T0:
TYLER T LEE R ISTER OF WILLS
7006 SUNDAYS LN 1 COURTHOUSE SgUARE
FREDERICK MD 21702 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
® CERTIF.
SOVEREIGN BANK provided the Departaent with the infonation Delow, which has been used in ealeuletine the
Dotential tax due. Records indicate that at the death of the above-naaed decadent, you were a ioint owns r/banef iciary of this account.
If you foal the infonation is incorrect, please obtain written correction frog the financial institution, attach a copy to this fora
and return it to the above adpress. This account is taxable in accordance with the Inheritance Tax laws of the Coaaom+ealth of
Pennsylvania. Please call (717) 787-8327 with questions. _
COMPLETE PART 1-BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1695540706 Data 01-20-2006 To ensure proper credit to the account, two
Established copies of this notice oust accoapam
Account Balance 1,193.90 payaent to Lhe Reaister of Wills. Meke chock
payable to "Reaister of Wills. Agent".
Percent Taxable X 50.000
NOTE. If tax payaents are wade within three
Amount Subject to Tax $ 596.95 aonths of the decedent's date of death,
Tax Rite X 15 deduct a 5 percent discount on the tax due.
Am Inheritance Tax due will beeoae delinquent
Potential Tax Due ~ $9.54 nine aonths attar the tlate of death.
E
A. ~ The above infonation and tax due is.correct.
Resit payaent to the Reaister of Wills with two copies of this notice to obtain
a discount or avoid interest, or chock box "A" and return this notice to the Reeister of
CHECK
C ONE ~ Wills and an official assassaent will be issued by the PA Departaent of Revenue.
BLOCK B. ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ON L Y to be filed by the estate representative.
C. ~ Tha above infona ion is incorrect and/or debts and deductions ware paid.
Coaplete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
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. Tex Due 8 S
PART DEBTS AND DEDUCTIDNS CLAIMED
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
Untlar penalties of perjury, I declare that the facts I have reported abQove are tr ep, ~orr/~e~t and ~~
~ complete to the best of my k~owladBe and belief. HOME C1r/~ ~ ) ~ ~/-~ T