HomeMy WebLinkAbout03-22-11 (6)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE _
BUREAU OF INDIVIDUAL rAxes -. AND FILE N0. 21'- l ~ - ~`~~ t
Po eox zaocol ~-`- ~~AXPAYER RESPONSE ACN 11115845
HARRISBURG PA nlzs-ocol - - ~ ~ ~; i~ DATE 0 3 - 08 - 2011
REV-1543 E%AFV (08-08) J
:~ _.~ ~ ._
FRANCES EWING
201 E MAIN STREET
LANDISBURG PA 17040
EST. OF AMBER M LEIBIG
SSN 187-44-9172
DATE OF DEATH 02-25-2011
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 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 ]oint 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 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. 700024599 Date 11-03-2006 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 ~` 8 ~ 223.19 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax ~` 1,370.5b months of the decedent's date of death,
Tax Rate )( .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ b1.bB nine months after the date of death.
PART TAXPAYER RESPONSE
AIL RESPOND W L7~I11~~ . FFICIAL TA ~\ ~~ ~dENT
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
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue.
BLOC K B. n The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y ~A+ 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 ~ 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
1
2 $
3 X
4
5
6 $
7 X
8 $
OFFICIAL 11SE OILY '"~ AAA
PA DEPARTMENT OF REVENUE ~~o
PAD
1 c
2 ~..~
3
4
5 ~.
b \...
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
~1 /^) / TOTAL (Enter on Line 5 of Tax Computation) S
Unger penaltie of rjur I declare that the facts I have reported above are true, correct and
compl to to the b t f knowledge and belief. HOME C )
woRK c717 ) 774-7435 3.~y_,~
,X PAYER SIGNATURE one, sq. TELEPHONE NUMBER DATE