HomeMy WebLinkAbout05-25-11 (4)BUREAU OF INDIVIDUAL TAXES
PO BOX 260601
HARRISBURG PA 17128-0601
REV-1565 EX •FR
PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
AND
YER RESPONSE
IC~ v`
T
FILE N0. 21 10-1189
ACN 11131038
DATE 05-09-2011
Agl # MAY 25 aM l # ~ 2t1
ao"~n
IRENE H RADABAUGH
402 ADAMS ST EXT
ENOLA PA 17025-2901
EST. OF EDGAR E ROCHE
SSN 172-36-1698
DATE OF DEATH 10-31-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU provided the Dapartaent with the infonation below, which has boon used in calculating the
potential tax due. Records indicate that at the death of the above-pawed decadent, you were a joint owner/benefici arv of this account
If you feel the inf araation is incorrect, please obtain written correction frog the financial institution. attach a copy to this fora
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coaaonwealth of
Pennsylvania. Please cell (717) 767-8327 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE-SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1198320640-S4 Date 10-05-1994
To ensure proper credit to the account, two
Established copies of this notice oust aeeoapany
Account Balance g 444.09 p~'•°^t to the Register of Wills. Make cheek
''
payable to
Register of Wills. Agent".
Percent Taxable X 50.000
Amount Subject to Tax ~` 222.05 NOTEt If tax pay^ents are made within throe
months of the decedent's date of death,
Tax Reto X ~ lrj deduct a 5 portent discount on the tax due.
Potential Tax Due Arpr Inheritance Tax dw will bacoaa delinquent
~` 33.31
nine aonths after the data of death.
P
T TAXPAYER RESPONSE
~
1
A. ~ The above info nation and tax due is correct.
Reait peyaent to the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoid interest, or chock box •'A" and return this notice to the Register of
0 N E Wills and an official assessaent will be issued by the PA Departaent of Revenue.
BLOCK B. ~ The above asset has been or will ba reported and tax Daid with the Penns
lv
i
I
h
i
D N L Y y
an
a
n
er
tance Tax return
to be filed by the estate representative.
C. ~ Tha above infona Xon is incorrre~ct and/or debts and deductions were paid.
Coaplete PART 2~ and/or PART 3LJ below.
PART If indicating a tlifferant tax rate, please state
rolationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Eatablishsd 1
2. Account Balance 2 S
3. Portent 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
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
70TAL CEnter on Lino 5 of Taz Computation) i
Undo p naltias 9
eom et to th~ b
_-
/ f per y, I declare that the facts I have
ast f my k wlodg and belief . reported anb ova
HOME C " /~ area t2rue,
) / -/~ correct and
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DATE