HomeMy WebLinkAbout04-18-11 (6)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
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PENNSYLVANIA INHERITANCE. TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
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SUSAN CARACCIOLO
201 E MAIN STREET
LANDISBURG PA 17040
FILE N0. 21-~~-~~t~
ACN 11117756!
DATE 03-17-2011
EST. OF AMBER M LEIBIG
SSN 187-44-9172
DATE OF DEATH 1~2-25-2011
COUNTY CUMIBERLAND
REMIT PAYM ENT AND FiDRMS T0:
REGISTER OF WILLS
1 COURTH OUSE SQIJARE
CARLISLE PA 1't013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
FIRST NB OF MIFFLINTOWN provided the Department with the information below, whicFi 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) 787-832 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Under penalties of perjury, at the facts I have reported above are true, correct and
complete to the best of my kn led lief. H O M E C ~
TAXPAYER SIGNATURE
WORK c 71 ~ ~ 774-7435
avid H. S~one~ ~sq, TELEPHONE NUMBER
DATE
IUTAL ctnter on Line 5 of Tax Computation) S