HomeMy WebLinkAbout04-07-11 (3)BUREAU OF INDIVIDUAL TAXES
PO BOX 200601
HARRISBURG PA 17129.0601
REY-1563
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
AND
_'-`~;F7(~iCPAYER RESPONSE
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FILE N0. 21 10-1231
ACN 111D3509
DATE 01-19-2011
7J~ I APR -7 F{j'i ~ 0: ~ ~ TYPE OF ACCOUNT
EST. OF BENJAMIN H SMART ® SAVINGS
S$N 185-38-6205 ^ CHECKING
r~CL~InEAR'KOF DATE OF DEATH 12-11-2010 ^TRUST
ORPI L"VV'S COURT RM IUrTT AYMENT AND MORMSLAOND ^ CERTIF.
a~~e~~~r~~ co . PA
HILARY J SMART REGISTER OF WILLS
APT 306 1 COURTHOUSE SQUARE
3300 DANILE LN CARLISLE PA 17013
MONROEVILLE PA 15146-5343
BELCO COMMUNITY CU provided the Dspartaent with the information below, which has boon used in calculating the
potential tax due. Records indicate that et the death of the above-named decadent, you were a ioint owner/banal iciary of this account.
If you feel the infonation is incorrect, please obtain writt an correction frog the financial institution, attach a copy to this fora
and return it to the above address. This seeount is taxable in accordance with the Inheritsnce Tax laws of the Cwmonweelth of
Pennsylvania. Please call C717) 767-8327 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 179610 Date 07-08-1987 To ensure proper eretlit to the account, two
Estab115hed copies of this notice oust accompany
Account Balance $ 6,264.40 pavmant to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax
1,044.09 NOTES If tax pevments are made within throe
months of the decedent's tlat• of tleath.
Tax Rata X .045 deduct a 5 percent discount on the tax tlue.
Potential Tax Due 4 6.98 Arty Inheritance Tax due will become delinquent
nine months after the tlat• of death.
PaT
1 TAXPAYER RESPONSE
A. ^ The above information and tax due is correct.
Raait payment to the Register of Wills with two copies of this notice to obtain
CHECK
0 NE a discount or avoid interest, or cheek box "A" and
Wills and an official assessment will be issued by return this notice to the Register of
the PA Department of Revenue.
[ BLOCK ~ 9. ^ The above asset has boon or will be reported and tax Deitl with the Pennsylvania Inhe ri tane• Tex return
ONL Y to be filed by the estate representative.
C. ^ Th• above informs Son is incorrect entl/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rata, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Hato Estabiisfi •d 1
2. Account Balance 2 ~
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 S
5. Debts and Deductions 5 -
6. Amount Taxable 6 ~
7. Tax Rate 7 X
8. Tax Dua 8 $
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above aro true, cor/re-cat d
complete to the best of my wledge an beliof. HOME C ~ ) 73 Z- ~IGZ~
WORK C ~ ~ Z~.~~~ /.~
AYER SIGNAT R TELEPHONE NUMBER D E