HomeMy WebLinkAbout08-04-11BUREAU OF INDIV IDWL TAXES
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WIRRISBURG PA 17128-0601 DEPARTMENT
REV-1563 EZ I~
PENNSYLVANIA INHERITANCE TAX I ~~
INFORMATION NOTICE FILE N0. 21 ' I ~~~
AND ACN 11149572
~, ;°'~"'"'~p~ PAYER RESPONSE
.~: C'~7C."l"JI*r DATE D7-25-2D11
~~
~'t,' I aJG "'4 t'~i a?~ 4t1
CLERK QF
rnr~~OuR`PFiAN'S COURT
JANICE C EVANS ulnnBERIANl~~•~ PA~r
75 SAM SNEAD CIR
ETTERS PA 17319-9565
EST. OF HORACE W EVANS
ssN zo2-D7-2787
DATE OF DEATH 06-03-2D11
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 informs tf on Del ow, wht ch was used in calculating the inheritance tax due.
Records indicate that at the death of the above named decedent, you were a ,point owner/beneficiary of this account. If you ere 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.reletionship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If yyou believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return
i t. to the abnve address, Please call 717,792-832) with questiens. -. -.. - - - -
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 5140487044 Date 01-17-2D07 7o ensure proper credit to the account, two
Established copies of this notice oust accompsny
Account Balance 13,533.00 payment to the Register of Wills. Make check
payable to "Register of Wills. Agent'
Portent Taxable X 50.000
NOTE: If tax payments era made within three
Amount Subject to TeX g 6,766.50 months of the decedent's data of death,
Tax Rate X .045 deduct a 5 percent discount on th• tax due.
Amr inheritance tax due will become delinquent
Potential Tax Due S 304.49 nine months after the date of death.
PART
CHECK
ONE
BLOCK
ONLY
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 antl
an official assessment will be issued by the PA Department of Revenue.
B. ~ The above asset has bean or will be reported and tax Daid with the Pennsylvania inheritance tax return
filed by the estate representative.
C. ~ The above info a ion is incorrect and/or debts antl tleductions were paid.
Complete PART ~ and/or PART ~ below.
PART If indicating a different tax rata, please state
a relationship to decedent:
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balanco 2 ~
3. Percent Taxable 3 X
4. Amount Subject to Taz 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Taz Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID