HomeMy WebLinkAbout06-03-11BUREAU OF INDIVIDUAL T _
PO BOX 280601 ~~~'' 'r
HARRISBURG PA 17128- 6U1 y~ /~
''-~ REW 1543 'Ek'ltF~'~~OB-08)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 .... ( I ~~~
ACN 11132307
DATE 05-11-2011
~'){~)CLE~K OF
Qflf"1 i/"1t~~~ VIJV~
Cl1~sR~R~.~w~r ~~., PA
ARTHUR F BARKET
530 PARK AVE
NEW CUMBERLAND PA 17070-1500
EST. OF IRENE M BARKET
SSN 202-24-6467
DATE OF DEATH 10-15-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIG N B ANK 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. 0574401808 Date 07-12-2006
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 7, 660.09 Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable )( 50.000
Amount Subject to Tax $ 3, 830.05 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate ~( ~ 15 deduct a 5 percent discounl: on the tax due.
Potential Tax Due $ 574.51 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
0 -
FAILURE TO RESPUND WILL RESULT IN AN OFFICIAL TAX ASSESSMENTI
~i
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.
B L 0 C K B. ~ le above asset has been or will be reported and tax paid with the Pennsylvania Inherittance 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
LINt 1. Dare Established 1
2. Account Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rate 7 X
8. Tax Due g $
OFFICIAL'USE ONLY [~ AAF
PA DEPARTMENT flF REVENUE
PAD
1
2
3
4
5
7
8,
Under penalti s of perjury, I eclare that the facts I have reported above are true, correct and
complete t e be of m kn le a and belief . HOME C 7/ ] ) 7 77 ~- ~~~~
WORK ( ~ - --
TAXPAYE G ATURE TELEPHONE NUMBER _ q~~ /~'
rarcl DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE nFC('RTPTTn~ _.._...._