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HomeMy WebLinkAbout04-14-11PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES :'.r_.t-., ,., AND FILE ND. 21~"~I~a~' +~~ .r Po Box 2ao6o1 ~~ ~ ' ' ~`"~'~y~CPAYER RESPONSE ACN 11112349 HARRISBURG PA 17128-0601 ~ ( `~- t ~~~~=.~~;~ ~~ ~";!~~ C~ REVISED NIOTICE * * * DATE 03-15-2011 REV-1543 EX AFP (OB-08) -' ' - c..~J `'"`) ~ ~~~~ f ~ ~~ TYPE OF ACCO i~ i °'~ ~`~' ~ ~+ EST . OF JACQUEL I N R STUART ^ sA CLERIC r~ SSN 18b-28-5943 ® cH Q~'PN~,~`, {F DATE OF DEATH 10 - 0 6 - 2 010 ^ TR ('1r e ~ ~vc~i~T COUNTY CUMBERLAND ^ cE ;P"~'~•~ (, } P~j REMIT PAYMENT AND FORMS T0: GEORGE E STUART REGISTER OF WILLS 8006 EVELYN STREET 1 COURTHOUSE SQUARE HUMMELSTOWN PA 17036 CARLISLE PA 17013 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS UNT VINGS ECKING UST RTIF. Account No. 1010147114673 Date 08-29-2006 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 $ 0 0 3.8 1 7, payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 3,501.91 months of the decedent's date of death, Tax Rate ~( .00 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due ~` .00 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 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 Wills and an official assessment will be issued by the PA Department of Revenue. ONE 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 3^ below. PART If indicating a different tax rate, please state ~; 2 relationship to decedent: ' ~ ~ „\ ~~ ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS p~~ ~ .~ LINE 1. Date Established 1 \ \ 2 Account Balance 2 $ ~ . ~~ ~ ~ 3. Percent Taxable 3 $ ~~ ~~ 4. Amount Subject to Tax 4 ~\ 5. Debts and Deductions 5 - ~~\\~ $ ~\ \~ 6. Amount Taxable 6 \ \ ~~ ~~ \ 7. Tax Rate 7 X ~ ~ $ ©~ ~~ ~~ ~\~~ \ 8. Tax Due 8 ~ ~ PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under nalties of jur declare that the facts I have reported above are true, correct and compl t to the f w dge and belief . HOME C ~ `~) ~5~z~''~ ~. `~ W O R K C ) ~ '~, ~ ,.. TAXPAY S TURE TELEPH NE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S