HomeMy WebLinkAbout04-12-11BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
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JESSIE ~~.`~ `~-~~~1~~
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MECHANICSBURG PA 17055
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
* * ~ REVISED NOTICE * * ~
FILE: N 0. 21 -~ ~ ~ 'U "l~ l.~
ACN 11117630
DATE: 03-24-2011
EST. OF JANET K WEIGEL
SSN 182-28-0558
DATE OF DEATH 04-30-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIG N BANK 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, attacFi 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. 2471706274 Date 06- 03- 1998 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 $ 24 ~ 854.78 pavable to "Resister of wi:Lls, Agent".
Percent Taxable X 5.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 1 ~ 242.74 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
0
FAIL!l:RE ~Tfi~ ~~POND WILL RESU1_T IN Aht D~FICiAL TAX ASSESSMENT
A. O~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 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 L___I below.
PART If indicating a different tax rate, please state ~ 4:F~jCiAL USE O~Y
relationship to decedent: ~ AA<F
PA DEPARTMENT OF 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 ~
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ ~
7. Tax Rate 7 X 7
8. Tax Due g $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMnIINT PATn
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
co~n~lete to the best of my knowledge and belief .
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C.~ ~'~ , .~ W O R K ( ~
TAX A ER SIGNATURE TELEPHONE NUMBER DATE
IUINL ~CnLer on pine 5 of rax Computation) $