HomeMy WebLinkAbout03-22-11 (11)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21'-,~'-~~~j
PD Box 2BO6o1 ` ' ir" TAXPAYER RESPONSE ACN 11115850
HARRISBURG PA 17128-0601 _ "`
''~ DATE 03-08-2011
REV-1'~~N3 ~% RFP (OB -OB) -
TYPE OF ACCOUNT
- ~ EST. OF AMBER M LEIBIG ® SAVINGS
SSN 187-44-9172 ~ CHECKING
r' =~`=~'' "~ = DATE OF DEATH 02-25-2011 ~ TRUST
4 ,:`~-, ;~ ',1:.=,,', COUNTY CUMBERLAND ~ CERTIF.
~`~P = ~"i~, REMIT PAYMENT AND FORMS T0:
SUSAN CARACCIOLO REGISTER OF WILLS
6632 PELHAMS TRACE 1 COURTHOUSE SQUARE
CENTREVILLE VA 20120 CARLISLE PA 17013
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 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 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. 068473184 Date 04-11-1994 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 $ 826.24 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 137.71 months of the decedent's date of death,
Tax Rate X , 12 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential TaX Due $ 16.53 nine months after the date of death.
PART TAXPAYER RESPONSE
a AID TO SPEND;.. ILLA~ , ULT N OF.~ICIAL TAX ASSE°SSMEHT
A. ~ The above information and tax due is correct.
Remit payment to the Resister of Wills with two copies of this notice to obtain
CHECK 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.
C ONE
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.
PART If indicating a different tax rate, please state OFFICIAL. USE~taNL~Y [~A~1F
relationship to decedent: PA DEPARTME~iT 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 Taz 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
0
TOTAL CEnter on Line 5 of iax computation) s
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my k e g elief. HOME C )
WORK c 71 7) 774-7435~~?
TAXPAYER SIGNATURE D Vld .` ri ~ E Sq. TELEPHDNE NUMBER DATE
DATE PAID PAYEE DESCRIPTION AMOUNT PAID