HomeMy WebLinkAbout04-18-11 (3)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANI:E
INFORMATION NOTICE
AND
•'~~' ' ~ ~_, ~I~PAYER RESPONSE
REV-1543 EX A.'.. ~ ~d"+S) ~ ~ !,.~` t ~1
TAX
FILE N0. 2r-I ~-~~?~~
ACN 11116007
DATE 03-09-2011
E 3 F ~ ~ ~ ~~ ~ U ~ E;,.~ ~ ~ i 1, J
CC.ERK ~;~
r„ ~ t.l~,f tJr t
** SUSAN CARACCIOLO
6632 PELHAMS TRACE
CENTREVILLE VA 20120
EST. OF AMBER M LEIBIG
SSN 187-44-9172
DATE OF DEATH 02-25-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WIILLS
1 COURTHOUSE SI~UARE
CARLISLE PA ;L 7013
TYPE OF ACCOUNT
SAVINGS
CHECKIN
TRUST
® CERTIF.
BANK OF LANDISBURG provided the Departwent with the inforwation below, whi~~h has been used in calculating the
potential tax due. Records indicate that at the death of the above-Hawed decedent, you were a joint owner/beneficiary of this account.
If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with the Inheritance 1'ax laws of the Cowwonwealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 700023317 Date 05-06-2010
To ensure proper credit to the account, two
Established copies of this notice wust accowpany
Account Balance $ 7, 675.79 paywent too the Register of Wills. Make check
payable too "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax ~- 3, $37.90 NOTE: If tax paywents are wade within three
wonths of the decedent's date of death,
Tax Rate ~( ~ 12 deduct a E> percent discount on the tax due.
Potential Tax Due g 460.55 Any Inheriitance Tax due will becowe delinquent
nine wonths after the date of death.
P~T TAXPAYER RESPONSE
1
,: _
Under penalties of
complete to the 6~
TAXPAYER SIGNAT
TOTAL (Enter on Line 5 of Tax Computation) ~g
I e 1 re that the facts I have reported above arE~ true, correct and
my wl d and belief.
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