HomeMy WebLinkAbout03-22-11 (7)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES _ ~ = i~~- AND FILE N0. 21 ~ ~ ('~~'~
Po eox zao6ol ,TAXPAYER RESPONSE ACN 11115846
HARRISBURG PA 17128-0601
~~ DATE 03-08-2011
REV-I543 E% AFP (OB-BB)
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SUSAN CARACCIOLO
6632 PELHAMS TRACE
CENTREVILLE VA 20120
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 point 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 (717> 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
ACCOUnt Balance $ 8 ~ 223.19 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax
~` 1 ~ 370.56 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate ~( , 12 deduct a 5 percent discount on the tax due.
Potential Tax Due
$
1 6 4.4 7 Any Inheritance Tax due will become delinquent
nine months after the date of death.
P~T
~ I. TAXPAYER RESPONSE
~ ~1,ILL ~ I . \ OF
IAL TA SSES~ENT
A. ~ Th e above information and tax due is correct.
Remit vayment to the Register of Wills with two copies of this notice to obtain
CHECK
0 N E a discount or avoid interest, or check box "A" and
Wills and an official assessment will be issued by return this notice to the Register of
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 ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3^ below.
9 please state
PART f indicatin a different tax rate, ...off OF~~CIAL' USE ~NL~~ ~ /~A~
relationship to decedent: PA DEPARTMENT OE REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD \
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X ~ 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 - ~~ 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 ~ 8
PART DEBTS AND DEDUCTIONS CLAIMED
^S
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of pe de ar that the facts I have reported above are true, correct and
complete to the best o my ow e g a d belief.
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TAXPAYER SIGNATURE 1 one, Esq. TELEPHONE NUMBER DATE
IUTAL ltnier on Line 5 of Tax Computation) S