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HomeMy WebLinkAbout04-15-11BUREAU OF INDIVIDUAL TAXES PO BOX 28060 - , ~~ ,~ HARRISBURG ~i4'~. 1.7.128-0.601 .._ , i ,` _ ~, ~~ .. .. _ ~ ~~V-1543 EX AFP (08-OB) PENNSYLVANIA, INHERITANCE INFORMATION NOTICE ,AND TAXPAYER RESPONSE TAXI FILE IVO. 21 -- ~ ~ -~' ~'~ `~ ACN 11123793 DATE 04-07-2011 t E ,JI s 1 LIDA IO HOWER 208 BYRON AVE HARRISBURG PA 17109-3103 EST. OF ROBERT E HOWER SSN 208-14-9708 DATE OF DEATH 12-01-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. WACHOVIA BK NA 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 C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1000654558541 Date 02-24-1988 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 16,832.83 payment to the Register of Wills. Make check payable to "Register of Will:>, Agent". Percent Taxable )( 50.000 Amount Subject to Tax $ 8,416.42 NOTE: If tax payments are made within three months of the decedent's date of death,, Tax Rate ~( ~ 15 deduct a 5 percent discount on the tax due. Potential Tax Due $ 1 , 262.46 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILUaE TO RESPOND WILL RESULT IN AN OFFICiAt TAX ASSESSMEN'T` 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. C. The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART lJ below. owor Tf .. .~: _i_ • -• -••--~o«~~y a u~rrerenL relationship to decedent - Lax rat ~ ~ please state ~~ ( ~--~ TAX LINE RETURN - COMPUTATION 1 . Date Es tabiisheu OF TAX ON JOINT/TRUST ACCOUNT ~ 'Z_ ~ Z Y , ~ t~- 2. Account Balance 2 $ 3. Percent Taxable 3_ X ~ ~ a s 4. Amount Subject to Tax 4 $ ~ d ~CI"~ 5. Debts and Deductions 5 - ~ © ~ Ur~' 6. Amount Taxable 6 $ n ~ ~~ 7. Tax Rate ~ X ~~,~ ~ ~ ~ 8. Tax Due 8_ $ ~ ~ ~-~ rs~rc ~ DATE PAID 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, correc,~ and complete to the best of my knowledge and belief. HOME C ~< 7 ~ .~~~~. SJ' f~ ~ ~7 C~a - ~Z~-1(,~-~G~~ W 0 R K ( ~ - TA PAYER SIGNATURE TELEPHONE NUMBER DATE DEBTS AND DEDUCTIONS f'1 AThlrn OFFICIAL USE DNLY ~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 4 5 6 7 8 r~ ~~ ~~: ~- i d ., . s ~< V~ '~ V V `~ 1~ J J V ~ ~J €4~ F,~~ ~~ i ;ti s..s i .~; i,..}