HomeMy WebLinkAbout03-22-11 (8)BUREAU OF INDIVIDUAL TAXES
PO BOX 260601
HARRISBURG PA 17128-0601
REV-1543 E% AFP (OB-OB)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE NO
f ~'~-~CPAYER RESPONSE ACN
~~ DATE
11115847
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 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-maned 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. 0709115 Date 04-01-1999 To ensure proper credit to the account, two
E stablished copies of this notice must accompany
Account Balance 37,533.43 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax
~`
6,255.70 NOTE: If tax paywents are made within three
months of the decedent's date of death.
Tax Rate ~( . 045 deduct a 5 percent discount on the tax due.
Potential Tax Due
~` 2 8 1 . 5 1 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
~~
LL RE E~' IN FF
ICI~AL~TAX AS !PERT
A. ~ The above information and tax due is correct.
Remit paym ent to the Register of Wills with two co pies of this notice to obtain
C H E C K a discount
Wills and or avoid interest, or check box "A" and
an official assesswent will be issued by return this notice to the Register of
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
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 ~ and/or PART O below.
PART If indicating a different tax rate, please state u~r~~~~r~~~ OBICIAL ~JSE ONLY ~~ AAF
2 relationship to decedent:
~ PA DEPARTMENT OF REVENUE
TAX RE TURN - 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 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perju ar that the facts I have reported above are true, correct and
complete to the best of y k pled ~;d belief. HOME C
WORK c717 ) 774-7435 ~ %/j
SIGNATURE Davi H. S ne, Esq. TELEPHONE NUMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) 8