HomeMy WebLinkAbout03-14-11PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU Of INDIVIDUAL TAXES ~. ~ -~ AND FILE ND. 21 - {I -~~,
PD Box zao6ol ~ ~ '~I~XPAYER RESPONSE ACN 11114992
HARRISBURG PA 17128-0601 FF ;eft!
REV-1543E%AFP~(~BRB)~ ,1 DATE 03-04-2011
CLERK CF
QRPH.A,N'S ;0! ART
C11~~~EFR:I_~fi~l"~ CC.: PA
THOMAS J BARTOS
2125 READING TURNPIKE
ELYSBURG PA 17824
EST. OF LOUIS C BARTOS
SSN 210-22-8286
DATE OF DEATH 02-12-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
CENTRAL KEYSTONE FCU provided the Departwent with the inforwation below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-pawed decedent, you were a joint owner/beneficiary of this account.
If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 55-010 Date 09-14-1959 To ensure proper credit to the account, two
Established copies of this notice wust accowpany
3 ~ 242.94 paywent to the Register of Wills. Make check
Account Balance $ payable to "Register of Wills, Agent".
Percent Taxable X 8.333
NOTE: If tax paywents are wade within three
Amount Subject to TaX $ 270.23 wonths of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will becowe delinquent
Potential Tax Due $ 12.16 nine wonths after the date of death.
PART TAXPAYER RESPONSE
t lSbl'- i~.fl /fY~ V,t• f~ A a-h.,a Y ~u au w -.~r~ ~. ~ ~.. ~...._.-_
CHECK
ONE
BLOCK
ONLY
above inforwation and tax due is correct.
Rewit paywent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the Register of
Wills and an official assesswent will be issued by the PA Departwent of Revenue.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid.
Cowplete PART 2~ and/or PART 3~ 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 <p
1 __
2 +~
3 X
4
5 -
6 $
7 X
8
PR DEPA.~~ltT ~' x~i~H~~ ''
r;
1 _ :.K .
2
3
4 - a
5 - - -
6
7
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TDTAL (Enter on Line 5 of Tax Computation] #
Under penalties of perjury, I declare that the facts I have reported above are tru/e,7correct and
comp ete to the best of my knowledge and belief. HOME C~ 7Q ) !O / ~ -~
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