HomeMy WebLinkAbout03-11-11 (5)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
AND
'~;tT~CPAYER RESPONSE
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REV-1563 E% ~fY (R1~•Ie) f_ _•J
T
FILE N0. 21 10-0872
ACN 11110553
DATE 02-21-2011
.il I "1-~i< i i r~,i`i Il~~ 4U
CLEP;K OF
ORPHAN'S COURT
CUMRPFi..q,°d~D CO, PA
BETTY E BENNETT
7006 SUNDAYS LN *R3
FREDERICK MD 21702
EST. OF GUST LEE
SSN 172-18-1751
DATE OF DEATH 08-05-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CNECKIN6
TRUST
® CERTIF.
SOVEREIGN BANK provided the Department with the information below, which has boon used in calculating the
potential tax dus. Records indicate that at the death of the above-named decedent, You were a ioint owner/beneficiary of this account.
If You teal the information is incorrect, please obtain rritten correction frog the flnancial 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 Commonwealth of
Pennsylvania. Plees• call t717) 787-8327 with questions. _ --
COMPLETE PART 1 BELOW A SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1695541324 Data 09-05-2006 To ensure Droper credit to the account, two
Established copies of this notice oust accomparo
priment to the Reaister of Wills. Make check
Account Balance ~` 1 i 128 • 76 priabl• to "Reaister of Wills, Agent".
Portent Taxable X 50 .000
NOTE: If tax Driments are wade within three
Amount Subject to Tax $ 564 .38 months of the decedent's date of death.
~ 1Fj deduct a 5 Da rcent discount on the tax due.
Tax Rat• ~( , Ary Inheritance Tax due will become delinquent
Potential Tax Due $ 84 .6 6 nine months after the date of death.
CHECK
C ONE
BLOCK
ONLY
Tho above infonation and tax due is correct.
Remit priment to the Rapistar of Wills with two copies of this notice to obtain
e tliseeunt or avoid interest, or check bmc "A" and return this notice to the Rapistar of
Wills and an official assessment will be issued by the PA Department of Revenue.
6. ~ The above asset has boon or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate ravresentative.
C. ~ The above info na ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3~ below.
ppR7 If indicating a,different tax rata, pleas' stet'
relationship to decedent:
TAX RE TURN - 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 antl Doductions 5
6. Amount Taxable 6 ~
7. Tax Rate 7 X
8. Tax Due B ~
PARr DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of par~ury, I declare that the facts I have reported above ar true, cor
and
c
t
o
I'a
,tompUte to th„! best of qpE knowledge and belief. HOMF (i~~~ ) t
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