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HomeMy WebLinkAbout04-12-11 (6)BUREAU OF INDIVIDUAL TAXES (^-~ ~ ~' .r-, "' i PO BOX 280601 ~ ~~~~_ _ _ HARRISBURG PA 17128-0601 ~i~-, ; ~ . . REV-1543 EX AFP (08-08) PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND TAXPAYER RESPONSE ~ ~ * REVISED NOTICE TAXI ACN 11117635 * DATE 03-24-2011 ~~~~~ n~ y,,_ ;. C~~~ t'~`~°_,''`'`~~~1 ~;'%t , gyp. JESSIE A WEIGEL 649 WILLOW WAY MECHANICSBURG PA 17055 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. SOVEREIGN 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, attache 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. 2471709532 Date 08-05-1996 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 19 ~ 702.20 payment to the Register of Wills. Make check Percent Taxable Payable to "Register of Wills, Agent". X 5.000 Amount Subject to Tax $ 985.11 NOTE: If tax payments are made within three Tax Rate months of the decedent's date of death, X . 0 0 deduct a 5 percent discount on the tax due. Potential Tax Due $ ~ 00 Any Inheritance Tax due wall become delinquent nine months after the data of death. PART TAXPAYER RESPONSE FAILU~tE TO RESPtiD WILL RESULT ..IN AN t1FFICIAL TAX ASSESSMENT: A. ® 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. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE i. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ r~arc i DATE PAID C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ 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. ` HOME ( ,7% 7 ~ ~~ `=;1/T TAXPA ER SIGNATURE TELEPHONE NUMBER DATE DEBTS AND DEDUCTIONS CLAIMED OFF~~IAL USf ONLY ~ AAP PA DEPARTMENT OF REVENUE PAD 1 2 3 4 5 6 7 8