HomeMy WebLinkAbout07-14-11BUREAU OF INDIVIDUAL TAXES '
PO BOX 280601 penn~,~~YY~~{
HARRISBURG PA 17128-0601 DEPARTMENT'[Ok...~R
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21" ~ ~ " ~~~~
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EILEEN KENESSEY
139 E CUMBERLAND RD
ENOLA PA 17025
EST. OF LOUIS KENESSEY
SSN 141-32-7482
DATE OF DEATH 01-25-2011
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 BAN 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 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 he information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
it to tine above address. Please call 7i7-787-83Z7 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0921711654 Date 08-11-1997 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 $ 8, 190 • 50 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 4, 095.25 months of the decedent's date of death,
Tax Rate ~( 1 Cj deduct a 5 percent discount on the tax due.
Anv inheritance tax due will become delinquent
Potential Tax Due $ 614.29 nine months after the date of death.
PART TAXPAYER RESPONSE
0 ~ ~
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.
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 If indicating a different tax t , please state ~~ ~ ~ ~
relationship to decedent:
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1 ~~
2. Account Balance 2 $ \
3. Percent 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 8
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties f perjury, I declare that the facts I reported above arer~true, correct and
~om lete to t e best of my knowledge and belief . HOME C ~ ~ / ) ~~ ~ ~ .3 $lO
` WORK C ) ~ -/~-/~
TAXPAYER SIG TURE TELEPHONE NUMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) $
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