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Home My WebLink About05-09-11 (4)PENNSYLVANIA INHERITANCE TAX ~~ ~\ INFORMATION NOTICE FILE N0. 21"~,-Q~p~~J BUREAU OF INDIVIDUAL TAXES ~ .,. Po Box Zso6ol ei'1 ~~ '-~~~''~ ~~ AND ACN 11145926 HARRISBURG PA I712B-o6ol p ~~"`~`" " ~ T AX P AY E R R E S P O N S E DEPARTME JJ~-06^~ttt~~~YEN33FJE ~ li `1~ S ~ DATE 0 7 - 13 - 2 U 11 REY-1543~EJF~~FP~~F'OS X71) ~ ~.-d~..'J Ci..FRK 4F QRPHA,N`~ COt~RT Cl1~~i"~i ~~~~~~ ~;~ . PA EUGENIA G MILLER 613 N EAST ST CARLISLE PA 17013-2012 EST. OF EVELYN E: STOUT SSN 152-14-0346 DATE OF DEATH (15-22-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FARMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 1 ~t013 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 y oU 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 the information is incorrect, please obtain written correction from the financial institut~~on, attach a copy to this form and return it to the abcve address. P?ease cal? 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6247704688 Date 09-06-2005 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 $ 104, 331.30 payable to "Register of Wills, Agent". Percent Taxable X 16 . b67 NOTE: If tax payments are made within three Amount Subject to Tax ~` 17 ~ 388 • 90 months of the decedent's date of death, Tax Rate ~( l~j deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 2 ~ 608 • 34 nine months after the date of death. PART TAXPAYER RESPONSE ssMEN`T 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 Regiister of Wills and C H E C K 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 they 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: \ ~ ~ ~~ ~~~\~ - LCULATION OF TAX ON JOINT/TRUST ACCOUNTS \\ ~ ~ ~~~~~~~~~~~~~~ TAX RETURN CA LINE 1. Date Established 1 \\` \~~~ \~ \\ ~ \ ~\ .~\ ~\ooo: ~ \0~ 2. Account Balance 2 $ \ ~` ~~ \~ \ ~\ 3. Percent Taxable 3 X S \ ~~\ \ \\\ \ 4. Amount Subject to Tax 4 $ `~ 5. Debts and Deductions 5 - ~ \\\\\\\~ ~ \ \~\ \\\ 6. Amount Taxable ~\ ~~ \ X ~ \\~~ ~~~~ ~~~ ~~ 7. Tax Rate ~ ~ ~ ~ 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 neTF Porn PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above"~are true, orrect~Jand(,~ `-~~~` complete to the best of my knowledge and belief . HOME C"T ~ ~ ) ~ ~ ~~7 ~ 1 ` ~ WORK C ) ~ D. . /~ . C PAYER S N TURE TELEPHONE NUMBER D E I U I AL CtnLer On Llne 7 yr I e,c ~.um~+u ~a «.,~~~ iy