HomeMy WebLinkAbout03-25-11BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
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FILE NO. 21
ACN 11117697
DATE 03-16-2011
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JOAN JARRETT
19 NORTH 23RD STREET
CAMP HILL PA 17011-3817
EST. OF KENNETH JARRETT
SSN 210-16-6584
DATE OF DEATH 01-20-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST F CU 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 I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 200278-43 Date 11-13-2007 To ensure proper credit to the account, two
Established copies of this notice must ac:companv
payment to the Register of Wills. Make check
Account Balance $ 53, 913.33 payable to "Resister of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 8,985.73 months of the decedent's date of death,
Tax Rate ~( 00 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $` .00 nine months after the date of death.
PART TAXPAYER RESPONSE
~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. .1 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
0 N E Wills and an official assessment will be issued by 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 Inh~er:itance 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 ONLY .[~ AAF
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
FINE 1. Dcte Established 1 1
2. Account Balance 2 +fi 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 - S
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. H 0 ME C ~
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WORK C
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TAXPA R SIGNATURE TELEPHONE NUMBER D TE Y
TOTAL (Enter on Line 5 of Tax Computation) S