HomeMy WebLinkAbout07-05-11PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
Po Box zao6ol TAXPAYER RESPONSE
HARRISBURG PA 17128-0601
REV-1543 EX AFP (OB-08)
FILE N0. 21--''~ ~ /~j
ACN 11136804
DATE 05-30-2011
LARRY R HETRICK
14 PADDOCK LN
CAMP HILL PA 17011-1268
EST. OF ELLA B HETRICK
SSN 210-26-6453
DATE OF DEATH 05-03-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA 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 C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140319032 Date O 1 - O 1 - 1981 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 5, 188.00 Payment to the Register of Wills. Make check
payable to Register of Wills, Agent .
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax ~` 2,594.00 months of the decedent's date of death,
Tax Rate )( . 045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due ~` 116.73 nine months after the date of death.
PART TAXPAYER RESPONSE
~~
A. n The above information and tax due is correct.
~l 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
Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance 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 3~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 \ ~ ~ "
2. Account Balance 2 +fi \
3. Percent Taxable 3 X ~ ~
4. Amount Subject to Tax 4
5. Debts and Deductions 5 -
6. Amount Taxable 6 $ e ~
7. Tax Rate 7 X , ~~
8. Tax Due 8 $ "`~
~~~~~.
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties o perju
complete to the~y~of/
TAXPAYER SIG
?I declare that the facts I have reported above are true, correct and
i
knowledge and belief. HOME C ) 7~~ - ~i6S
/ WORK C ) . d y~/.'
TELEPHONE NUMBER A E
TOTAL CEnter on Line 5 of Tax Computation) S
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
HETRICK LARRY R
14 PADDOCK LANE
CAMP HILL, PA 17011
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 210-26-6453
FILE NUMBER: 211 1-0737
DECEDENT NAME: HETRICK ELLA B
DATE OF PAYMENT: 02/ 1 5/201 2
POSTMARK DATE: 07/01 /201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 05/03/201 1
REV-1162 EX111-96)
NO. CD 015594
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11136804 ~ 5116.73
TOTAL AMOUNT PAID:
REMARKS:
51 16.73
CHECK# 40007
INITIALS: CJ
SE~.L RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
~~ ~~~ REGISTER OF WILLS
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