HomeMy WebLinkAbout08-04-11 (2)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 ~)~'
BUREAU OF INDIYIDUAL TAXES
Po cox zao6ol pennsylvan' ~ AND ACN 11149571
HARRISBURG PA 17128-0601 (}~'~,rr., R RE S P O N S E
DEPARTMENT OF REVEN - !., . ~,-,'1 },~'A R'A6 DATE D7-25-2D11
eEY-1565 E% aFP tE5-Il> r..,~ `,~~`• VF
' '"` TYPE OF ACCOUNT
,~; ~ ~~~ ..(~ F~ ~~, T. OF HORACE W EVANS ^ sAVINCs
N 202-07-2787 ^ cHECKINs
GL~RK QF DATE OF DEATH 06-03-2011 ^ TRUST
/~p~~,,,~h~,' ~+ (~ COUNTY CUMBERLAND ® CERTIF.
'~Allr' WY~~7 V~,JU~ REMIT PAYMENT AND FORMS TD:
JANICE C EVANS ~~~R~.~~~~,. REGISTER OF WILLS
75 SAM SNEAD CIR 1 COURTHOUSE SQUARE
ETTERS PA 17319-9565 CARLISLE PA 17013
PNC BANK NA Drovidetl 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 y0U are the Spouse Of the
deceased and any amount other than zero 1s reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the deDertment of your relationship to the deceased by checking Box C 1n PART 1 below and writing "spouse" in PART 2.
If you believe he information is incorrect. Dl ease obtain written correction from the financial lnsti tuts on, attach a copy to this form and return
it t0 .the. above address .. _-Please Gall. 71Z-787-8327 with Questions. _ -
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 31600314768 Date 07-05-20D7 7o ensure proper credit to the account, two
Established copies of this notice must aeeompariy
payment to the Register of Wills. Make chock
Account Balance ~` 8.069.00 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE, If tax payments •re made within three
Amount Subject to TaX $ 4, 034.50 months of the decedent's data of death,
Tax Rate X . 0 4 5 deduct a 5 pe rcant discount on th• tax due.
Arty inheritance tax due will become delinquent
Potential Tax Due ir` 181.55 nine months after th• date of death.
PART TAXPAYER RESPONSE
1^
A. ^ The above information and tax due is corre et.
Remit payment to the Register of Wills with two cgpias of this notice to obtain
CHECK 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 Ravanue.
C 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 %on is incorr ct and/or debts and deductions ware paid.
PART ~2 and/or PART ~ below
C
l
t
pmp
a
• .
PART If indicating a different tax rate, 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. lax Rate 7 X
8. Tax Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) 4 ~'
Under penaltios of perjury, I declare that the facts I reported above are true, correct and
complete to the best ofjy{Jenoifledge and b~f~ HOME ( )