HomeMy WebLinkAbout04-18-11BUREAU OF INDIVIDUAL TAXES r,~;r. ~ f ~P~r
PO BOX 280601 ' '- `~_
HARRISBURG PA 17128-0601 ± ~~.~ ,r:~ , ~
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REV-1543 EX AfP (OB-08)
PENNSYLVANIA INHERITANCE; TAX
INFORMATION NOTICE
~ AND
TAXPAYER RESPONSE
FILE N0. 21°'~~"U ~qGi
ACN 11113573
DATE 03-01-2011
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CLERK
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MARK M FREDA
PO BOX 333
MECHANICSBURG PA 17055-0333
EST. OF ARTHUR ,A FREDA
SSN 173-16-1682
DATE OF DEATH 12-18-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILILS
1 COURTHOUSE SQUARE
CARLISLE PA 1'7013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PN C BANK 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 C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5005799758 Date 09-28-2009 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 $ 5, 383.95 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 897.34 months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due $ 40.38 nine months after the date of death.
PART TAXPAYER RESPONSE
~ ~ \~ ........ \, ~ ~ ~ \~ ~#°.°• .~• ~ ~~:AL TAX ASSESSMENT
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
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
BLOC K B. ~he 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 ~~•' ~~`~` \
relationshi to decedent: ~ ~~\~~~~~~~~~~~~~ ~~"~~~~\\\\\`\ \\
P
2 \~ \ ~A DEPARTMENT \\ VENUE ` `•
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~; \ ~~~ \~
_, ~y\ ~A•
LINE 1. Date Established 1 ~~\\~\\~~~~~~
2. Account Balance 2 $ \
3. Percent Taxable 3 X \ \~"°0 ~~~~~~~\~~~
4. Amount Subject to Tax 4 \\ ~...\
5. Debts and Deductions 5 - ` \~\~~~ ~\~~~~~~\
6. Amount Taxable 6 $ ~~ ~ ~~\ ~~.~ .~~~~~~~\\\
~ ~•
7. Tax Rate 7 X '~\ \ ~ •~ ~~\~~\ ~~ ~ '~
8. T a x D u e $ ~~~ ~\.\..u.\~~~~
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
c plete th__e best~my k ledge and belief. HOME C :1
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TAXPAYER SIGNATURE
TELEPHONE NUMBER
DATE
TOTAL CEnter on Line 5 of Tax Computation) 8