HomeMy WebLinkAbout03-22-11 (3)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543E% ~iP (08-06)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 ~ (r-C'~G.`j
- ~TAXPAYER RESPONSE ACN 11115841
(,i.-
DATE 03-08-2011
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FRANCES EWING
201 E MAIN STREET
LANDISBURG PA 17040
EST. OF AMBER M LEIBIG
SSN 187-44-9172
DATE OF DEATH o2-25-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
BANK OF LANDISBURG provided the Department with the infornation 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 ioint owner/beneficiary of this account.
If you feel the infornation 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 Tax 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. 700023318 Date 11-29-2006 To ensure proper credit to the account, two
Established copies of this notice must accompany
5 1 3.5 3 payment to the Register of Wills. Make check
Account Balance $ 14 ~ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax ~` 7,256.77 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due g 326.55 nine months after the date of death.
PART TAXPAYER RESPONSE
1^
FAI TO' R~ WI ~ T~~~tN IDIAL T11X.,Ar,SS T
A. ^ The above information and tax due is correct.
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 notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
BLOC K B. ® The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
O N L Y to be filed by the estate representative.
C. ~ The above informs ion 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
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. lax Rate
8. lax Due
OF TAX ON JOINT/TRUST ACCOUNTS pp,D
1
2
3 X
4 +~
5
6
7 X
s $
PART
~~~ ~OEFICiAL USE ON~~
PA DEPARTlIENT OF REVENUE
1
2 ~.u
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under Pena
complete to t
TAXPAYER SIG
of perj , I declare that the facts I have reported above are true, correct and
s o knowledge and belief. HOME C )
WORK c 717-7)74-7435
H. Stone, Esq.
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DATE L~
TOTAL CEnter on Line 5 of Tax Computation) S