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Home My WebLink About07-15-11 (4)PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND F I L E NO. 21 PO BOX 280601 HARRISBURG PA 17128 p~{;~~.`j~;_~,.;~', TAXPAYER RESPONSE ACN 10162279 -- ~(( ((1~ DATE 11-02-2010 __. ray ~., .a RSV'-4543 ~X AFA-~C OB-08) ~L.ERK ~F IoRP~N~s ~;ouRT ** KATHLEEN ~''E" SAD~~~C~K~ ~~' P~ 3512 RIDGEWAY RD HARRISBURG PA 17109 EST. OF JAMES A THORNE SSN 160-36-4310 DATE OF DEATH 10-17-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. METRO BANK 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 7760448402 Date 08-17-2010 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 39 ~ 008.76 payment to the Register of Wills. Make check payable to 'Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to Tax $ NOTE: If tax payments are made within three 39 ~ 008.76 months of the decedent's date of death, Tax Rate ~( ~ lj deduct a 5 percent discount on the tax due. Potential Tax Due $ 5 ~ 851.31 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 0 FAILURE TO RESPOND 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 check box "A" and return this notice to the Register of 0 N E Wills and 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 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 ~ ~ OFF~~ICIAL USE ©h~1.Y ~ \ relationship to decedent: ~~ ,[~'~~AA~? PA DEPAf~TMENT OF REiIENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X ~ 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductians 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMn~lAir DATn Under penalties of perjury, I declare that the facts I have reported above are true, correct and compl e t e best of my knowledge and belief. H 0 ME C ) WORK C ) 7 /~~/ TAX AYER SIGNATURE TELEPHONE NUMBER AT iv~r.~ ~~n~er on Llne 5 Ot IaX Computation) $