HomeMy WebLinkAbout03-21-11PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL rAxes _ AND FILE N0. 21 ~ l_D .~L~'s
Po eox zaocol .. ,_Y'AXPAYER RESPONSE ACN 11115627
HARRISBURG PA lriza-ocol •*~ .~.,• * REVISED NOTICE * * * DATE 03-16-2011
REV-1543 ~E%AFP(88 -R B) ~ -
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PATRICIA S SHEAFFEi~
311 BELLAIR PARK RD
CARLISLE PA 17013
EST. OF H W SHEAFFER
SSN 200-22-5198
DATE OF DEATH 09-09-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIGN BANK provided 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 copy 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. 2894077793 Date 05-28-2008 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
AcCOUnt Balance $ 5,809.67 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 2, 904.84 months of the decedent's date of death,
~( , 00 deduct a 5 percent discount on the tax due.
Tax Rate Any Inheritance Tax due will become delinquent
Potential Tax Due $ • 00 nine months after the date of death.
PART TAXPAYER RESPONSE
ILL ~T~I `1WV OFF QIAL TAX A' SESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register 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.
ONE
C
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 ion is incorrect and/or debts and deductions wer~z paid.
Complete PART ~2 and/or PART 3~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
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
OF TAX ON JOINT/TRUST ACCOUNTS PAD
z $
3 X
4
5
6 '~
7 X
8
PART
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PA DEPARTMENT OF REVENUE
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3 ~~
4
5
6 ~\
7 -
DEBTS AND DEDUCTIONS CLAIMED
naTE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported ab~o/ve are true, co~rirect-7a/nd
complete to the best of my knowledge and belief. HOME C / ~ ) ~~~'s~ / fv
...- ~ WORK C ) .j /~'/j
AXPAYER SIGNATUR - TELEPHONE NUMBER DATE
1DIAL ctncer on Llne ~ yr ia,c ~amNu~a.+~~~.