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HomeMy WebLinkAbout09-16-11BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 i pennsylvania DEPARTMENT of REVENUE REV-1543 EX AF ~(OS-1 f t CAROLYN A RUSSEK T DR PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE _ a_.l I U ( ~ ~, Cl_~~~~ Q~ ~ I ,~hJ'~ r!'. !RT ., C1' ~ .;~!_F ~ 718 KEN MECHANICSBURG PA 17050-2220 DEBTS AND DEDUCTIONS C TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. rovided the department with the information below, which was used in calculating the inheritance tax due. CITIZENS BANK OF PENNSYLVANIA p Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of thi; account. If yoU are the Sp0U5e Of t e deceased and any amount other than zero is reflecned,beeowconethonPftomnthelfinanciDaleinst tutnoneattath a mopY'bo dhe form andUreturt notify the department of your relationshease obtae deceased by checking Box C in PART 1 below and writing spouse" in PART 2. If you believe the information is incorrect, p 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. 6140186080 Date 05-31-1990 To ensure proper credit to the account, two copies of this notice must accompany Established payment to the Register of Wills. Make check $ 7 ~ 987 , 25 payable to "Register of Wills, Agent". Account Balance 50.000 Percent Taxable X NOTE: If tax payments are made within three $ 3,993.63 months of the decedent's date of death. Amount Subject to Tax 15 deduct a 5 percent discount on the tax due. T aX Rate X Anv inheritance tax due will become delinquent $ 599.04 nine months after the date of death. Potential Tax Due TAXPAYER RESPONSE PART ALLURE TO RESPOND WILL .RESULT IN AN OFFICIAL TAX ASSESSMEN q, ^ The above information and tax due is correct. Wills with two copies of this notice to obtain Remit payment to the Register of this notice to the Register of Wills and a discount or avoid interest, or return the PA Department of Revenue. C H E C K an official assessment will be issued by ONE orted and e tax paid with the Pennsylvania inheritance tax return C B L 0 C K p B. ~ The above asset has been or will be r i ve. filed by the estate representat 0 N L Y IR The above informs ion is incorrect and/or debts C and deductions were paid. . te PART 2~ and/or PART ~ below. l e Comp nr n-i, v (~ AAF PART If indicating a different t~ n~?ti>GPleas a~stt~e~ relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE I. 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. Tax Rate 7 X o T~v n(~a B $ PART DATE PAID PAYEE ~`.3/, ~r ~ SSFK ~ _ r~ ~G ~ / ~ PA DEPARTMENT OF REVENUE PAD 1 2 3 4 6 7 8 LAIMED-~"r ti~e~V JJc i i t~ `/~,g~ 7~ ~~~~~~''~'~'~' DESCRIPTION EST. OF HAROLD RUSSEK SSN 054-24-0305 DATE OF DEATH 08-23-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 I~}~E~ CQYdY1F}('IOII)~ t-UAir"'yt/ -c E ~ TOTAL CEnter on Line 5 of Tax Computation) ~i7r~~ r3 AMOUNT PAID '7( °7 i •zS ~ Qzc a ~ l9rti Bey `{" s -~S'r~l.].L . ~v Under penalties of perjury, I declare that the facts I reported above are true,r7co'~eC~~ 1 ~ E,/i ~/, omPlete to the best of my knowledge and belief. HOME ~ ~~~~ ~ / ~/ 'l ~ WORK ( ~ ~D,1~Lt-rl. I~~_ ~~-~~/ TELEPHONE NUMBER DATE ~, ~_. FILE N0. 21-~~-~--~ 1~7 ACN 11160880 DATE 09-09-2011 ~XPAY R SI NATURE rI „~_ `J ~ ~ -. ~~„\ '~, ~~., ~ , ~- ~~ ~ ~. ,~. ~ ~. ~, ~~ ~~ ~ ~.' ~ ~. c` ~~ ~ . ~ ~ l i ~ " ' ~. ~ ~:~ ~~; ~~ . ~',~ t t ti~ t't`Y ~ ~ ~~' W r-i ~ ~,+ ~.~ "i'I ,.±~ '3 0:, f .- f.~ rrE _ i ~~, r ~~ ~ ~~ '~~.~~. f~ ~ ~p 7~ ~. ~~ '4. Ti a3naaob, vi -i ie srf4, t ~\ .y ,~,