HomeMy WebLinkAbout07-25-11~ PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE Q ~~
BUREAU OF INDIVIDUAL TAXES ~ - ~ ~ f /~nry -~ ~ _ _ w ND F I L E NU . 21 - ~l' /
PO BOX 280601 enns ~Van18 ~'~-''•r' ~ ' ~ ~ ~~ ~''~ ~1~++
HARRISBURG PA 17128-0601 ~ Y - ~ ) ACN 1114284
DEPARTMENT OF REVENUE ~r`~, ~` ,'T A~`^~R RESPONSE DATE 06-24-2011
REV-1543 E% AFP (05-11) ~ '' ''..L,~J
~~tt~! J~~ ~~ TYPE OF ACCOUNT
~~ ~' ~~T. OF ROBERT A LIDDICK ^ savlNCs
C~-FR~t Q(= DATE OF DEATH820681552011 ^ CHECKING
ORPNq~ r~ !~ TRUST
C(JMh F"~ ly~'JOURT COUNTY CUMBERLAND ~ CERTIF.
!7r ~'~ ~~ r( j PA REMIT PAYMENT AND FORMS T0:
BRANDON LIDDICK REGISTER OF WILLS
940 SOUTH 30TH STREET 1 COURTHOUSE SQUARE
CAMP HILL PA 17011 CARLISLE PA 17013
MEMBERS 1ST F CU 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 the 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 717-787-8327 with Questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 249614-41 Date 08-17-2004
To ensure proper credit to the account, two
Establ ished copies of this notice must accompany
Account Balance ~• 707
45 payment to the Register of Wills. Make check
. payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax
$
353
73 NOTE: If tax payments are made within three
. months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Potential TeX Due
$
15.92 Any inheritance tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPON SE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. I..#'The above information and tax due is correct.
LJ 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
0 N E an official assessment will be issued by the PA Department of Revenue.
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 3^ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Uate Establishetl 1 r 1
2. Account Balance 2 $ I 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ g
TOTAL CEnter on Line 5 of Tax Computation) $
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of my knowledge and belief. HOME C )
WORK ( ) }"'
TAXPAYER SIGNATURE TELEPHONE NUMBER D'
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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