HomeMy WebLinkAbout03-21-11BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
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REV-154b E% AFP cba-bey '
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
-~~- TAXPAYER RESPONSE
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FILE N0. 21 -( `~ •,a
ACN 11113572
DATE 03-01-2011
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MARGARET FREDA
4b9 BETHANY DR
MECHANICSBURG PA 17055-4360
EST. OF ARTHUR A FREDA
SSN 173-16-1682
DATE OF DEATH 12-18-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FCIRMS TD:
REGISTER OF WILLS
1 COURTHOUSE SQLIARE
CARLISLE PA 17'013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA Drovided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent. you were a joint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, attach a cape to this form
and return it to the above address. This account is taxable in accordance with the Inheritance Ta:% laws of the Commonwealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5005799758 Date 09-28-2009 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 5 ~ 383.95 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
AmOUnt Subject to Tax $ 897.34 months of the decedent's date of death.
Tax Rate ~( , 00 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due ~ .00 nine months after the date of death.
PART TAXPAYER RESPONSE
FAInLdU#tE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
IL] Remit payment to the Register of Wills 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 inotice to the Register of
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informs bon is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3^ 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
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
1
2
3 X
4
5 -
6
7 X
8
PAD
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above acre true/, correct a/nd
complete to the besct.~of my knowledge and belief. HOME C ~ ~ / .) ~~ (~ ' [ ~' 6
~fi~/z-cam' 7~en..~~-ate W O R K ( )
XP YE SIGNATURE TELEPHONE NIJMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) S