HomeMy WebLinkAbout06-20-11 ~~ PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 11-0092
BUREAU OF INDIVIDUAL TAXES
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HARRISBURG PA 1712E-0601 DEPARTMENT r,~v€rr~-
~ ~., ~~, , AXPAYER RESPONSE
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DATE
06-17-2011
REV-1543 E~! ~O4`-11'f' .
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TYPE OF ACCOUNT
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EST. OF LARRY E LIPPERT
' ~ SAVINGS
SSN 161-34-4537 ~ CHECKING
C~.ERK ~~ DATE OF DEATH 11- 27 - 2010 ~ TRUST
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~f LVii'~'S COURT COUNTY CUMBERLAND
O ~ CERTIF.
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CjtJly}~~~~_~~~ r~„ ~j4 REMIT PAYMENT AND FDRMS T0:
AUDREY L LIPPERT REGISTER OF WILLS
520 N BEDFORD ST 1 COURTHOUSE SQUARE
CARLISLE PA 17013-1913 CARLISLE PA 17013
CITIZENS BANK OF PENNSYLVANIA provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you are the Spouse of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe the information is incorrect, please obtain written correction frop~ the financial institution, attach a copy to this form and return
it to the above address. Please call 717-787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6100728005 Date 05-14-1973 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 $ 6 ~ 248.30 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject t0 Tax $ 3 ~ 124 • 15 months of the decedent's date of death,
Tax Rate ~( lj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 468.62 nine months after the date of death.
PART TAXPAYER RESPONSE
1^ __
FAILURE TO~.~RESPDND WILL RESULT IN AN OFFICIAL 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 return this notice to the Register of Wills and
an official assessment will be issued by the PA Department of Revenue.
C ONE
BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
0 N L Y 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
TAX
LINE
If indicating a different tax rate, please state \\
relationship to decedent:
RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
1. Date Established 1
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
2 $
3 X
4 $
5
6 $
7 X d
8 $
0
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
TOTAL CEnter on Line 5 of Tax Computat>.on~ s
Under penalties of perjury, I declare that the facts I reported above+.a~re true, correct and
c plete to the best of my k owledge and belief. HOME C ( ~~ ) ~ ~ "~
~ _ ~ WORK C )
TAXPAYER SIGNA RE TELEPHONE NUMBER DATE
DATE PAID PAYEE DESCRIPTION AMOUNT PAID