HomeMy WebLinkAbout04-18-11BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 ~- n,(' r-;-. _,,..'
HARRISBURG PA 1'~=~Q~1 . , ;,~
R~~N-1~3 X AFP (OB-08)
' IMF =. ~ " ~
4.. '-
~~.ER~; Q~
Q~PNA~''S ~~~I.)~T
FRANCES EWING
201 E MAIN STREET
LANDISBURG PA 17040
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 "~f -d~(~
TAXPAYER RESPONSE ACN 11116005
* * * REVISED NOTICE * ~ * DATE 03-09-2011
EST. OF AMBER M LEIBIG
SSN 187-44-9172
DATE OF DEATH 02-25-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
BANK OF LANDISBURG 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 (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 700023315 Date 05-06-2010 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 $ 91 , 444.90 payable to "Register of Wills, Agent".
Percent Taxable X 100.00
NOTE: If tax payments are made within three
Amount Subject to Tax $ 91 , 444.90 months of the decedent's date of death,
Tax Rate ~( .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 4, 115.02 nine months after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with twos 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 ~ below.
PART If indicating a different tax rate, please state ~~ ~ ~~ ~~ ~
relationship to decedent: \ ~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 ~\\ ~ ~ ~ \~ \ \
2. Account Balance 2
` \ e\
3. Percent Taxable 3 X ~~ \ O
4. Amount Subject to Tax 4 $ ~\\ ~ ~ ~ ~\
5. Debts and Deductions 5 - ,~~~°~ ~~
6. Amount Taxable 6 $ ~
7. Tax Rate 7 X ~ \ ~~~ ~ \
8. Tax Due 8 $ \\\ ~ ~ \ ~~~ ~~~~ \~~~ ~~O\
~\.
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I
complete to the best of my k~
AVER SIGNATURE David H.
t the facts I have reported above are true, correct and
lief . HOME t )
WORK c717 ~ 774-7435
,Esq. TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) S