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HomeMy WebLinkAbout05-09-11 (2)~~~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 ^l~ (~47~7 BUREAU OF INDIVIDUAL TAXES ~ ~~~, 1 ;,_~~,~ ,. AND ACN 11145924 PO BOX 280601 enn 4 = ~ ~ HARRISBURG PA 17128-0601 DEPARTMEN ~E1lEN ' ;~,~ "TAXPAYER RESPONSE DATE 07-13-2011 REV-1543 EX~tAPE~!(~~Ob~kl.1 .`r.v ~ i'._L.~1 ,~~~ ~ .~~L ~0 f~'~ ;3~ G~LERK OF QRPI-~1N`S COURT EUGENIA G MILLER 613 N EAST ST CARLISLE PA 17013-2012 EST. OF EVELYN E STOUT SSN 152-14-0346 DATE OF DEATH 05-22-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 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 de artment 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 the above address: Please call 7I7-781-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6100731944 Date 06-06-1966 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 ,ti` 41 , 444.03 payable to "Register of wills, Agent". Percent Taxable X 1b.667 NOTE: If tax payments are made within three Amount Subject to Tax ~` 6 , 907 • 48 months of the decedent's date of death, . 1 5 deduct a 5 percent discount on the tax due. Tax Rate X Any inheritance tax due will become delinquent Potential Tax Due $ 1 , 036.12 nine months after the date of death. PART TAXPAYER RESPONSE \ \ \ ~ . ,~ ,\ ~S~~NT. A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and C H E C K 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 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 rate, please state \\ relationship to decedent: ~~ \ a TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS \\ ~ \ \~ \\~~ \ ~ \ \\\ LINE 1. Date Established 1 ~ s~~~~ ~ ~~~~~::~ ~ $ 2. Account Balance 2 ~ \\ ~ ~ \ ~~~ ~\ ~~ 3 X 3. Percent Taxable ~~ \\ \\\\\ ~ \ 4. Amount Subject to Tax 4 $ - 5. Debts and Deductions 5 \\\\\~~ ~~\~\\\\\\ ~\ \~ 6. Amount Taxable 6 $ \ \ ~~~~~~~\\\ \ ;~\ ~~~~\\\\\ 7 . T a x Rat e 7 $ \~ ~ ~~~~~~~~~o~~ \O \ ~ \ ~ 8. Tax Due 8 ~ _~~ ~~ \~~~~' ~~~ DEBTS AND DEDUCTIONS CLAIMED PART 0 TATC DATT1 PAYFF DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, rre~t an complete to he best of my knowledge and belief . HOME C ~ ~ ~ ~ ~~ z ~ W O R K C ) ,,,?~ T PAYER S GNATURE TELEPHONE NUMBER DA U I AL ltflief' uIl L111C J y l .+~..~r`• ~•" ---••_