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Home My WebLink About06-27-11 (4)~~~\~ ;~\' PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE - ~- BUREAU OF INDIVIDUAL TAXES - AND FILE NO. 21 - ? ~ .~L' Po sox 2BO6o1 `~~` ~' ACN 11140463 HARRISBURG PA 17128-0~1~ ~~ -~~~~~~ p~- ~~a ~ DEPARTMENT '1 F~(ENUE TAXPAY E R R E S P O N S E ~~-'.µ.. ...,; ~ :., REV-1'543 Ek'pFB.~{A5-11) DATE 0 6 - 14 - 2 011 CLERK C~ ORPH~'S CQURT Cl)MRFR~1~.~~~:~ ~~ . PA. EDWIN L RICE 603 S BEDFORD ST CARLISLE PA 17013 EST. OF NAOMI J RICE SSN 184-38-0989 DATE OF DEATH 12-24-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. S 0 V E R EIG N B A N K 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 bey 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 from 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. 1674000219 Date O1 -O1 - 1971 To ensure proper credit to the account, two Established copies of this notice must: accompany Account Balance $ 2 ~ 113.2$ payment to the Register of Walls. Make check payable to Register of Will:>, Agent". Percent Taxable X 50.000 $ NOTE: If tax payments are made within three Amount Subject to Tax 1 ~ 056.64 months of the decedent's dlate of death, Tax Rate X 15 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 158.50 nine months after the date o1= death. PART TAXPAYER RESPONSE FAILURE TO RESPOND SILL RES~1.T 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 Resister of Wills and 0 N E an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inh~er'itance tax return 0 N L Y filed by the estate representative. C.^ DV The above intorma ion is incorrect and/or debts and deductions were paid. /~~ Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, p ~e„rase state QFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ Z 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION nMn~iNr pern Under penalties of IDerjury, I declare that the facts I reported above are true, correct and complet to, the b~c t of my k owledge and belief. HOME (~ r~~~~-~,- ~~~~~ WORK C ) TAXPAYER TURE TELEPHONE NUMBER nerF ~~+~~+~ ~~n~rr on amine 5 OT IaX computation) $