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HomeMy WebLinkAbout06-03-11 BUREAU OF INDIVIEJfy~'1rCL~-~, +rti,••,~. PO BOX 280601 ~./ti.. .E„~~,f,~ ;,_ ~t^: ~{ HARRISBURG PA 17 ~ ~ ;:•. ~ ~ htE~'~ik47/EX AFP C08-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 - t~-U~~~ ACN 11134830 DATE 05-24-2011 ~+I,CR~ ~R ~ ~'T ~} ~,~~ , BETTY L RINEHART ~~ ~-~I'yl~.~~,( SHIPPENSBURG PA 17257 EST. OF WILLIAM E RINEHART SSN 190-16-1997 DATE OF DEATH 02-27-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PAT RIOT FCU 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 ]oint 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. 1533870-00 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 04-06-1987 Established $ 2,132.72 X X PART T 16.667 355.46 _ .00 r 0 0 ER PONSE Under penalties of perjury, I declare that the facts I have reported above are true, correct and ~omplete to the be of my knowledge and belief . HOME c ~,' -} ) S ~- ' ?S ~ G~rw~.-S. C_2L ~ v (Q c-l ~ - (~ -I~ c `~l ? ~ 3 C.ctO - -XPAYER SIGNATU /~ ~(f~(~ TELEPHONE NUMBER DATE To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. TOTAL tEnter on Line 5 of Tax Computation) ~