HomeMy WebLinkAbout10-05-11 (2)~, PENNSYLVANIA INHERITANCE TAX
-~ INFORMATION NOTICE FILE N0. 21 11-0165
• BUREAU OF INDIVIDUAL TAXES rr•i `~~ir' ~ '~ r AND
Po eox 2BO6ol ~rai~SyLVam~i . ~t ACN 111b2540
HARRISBURG PA 1712E-0681 Q£hARTMEN70FRfVENUE~'i ~ ~ TAXPAYER RESPONSE DATE 09-21-2011
REV-1543 E% RfP (OS-I1) '~ J
_ TYPE OF ACCOUNT
~'"'~ EST. OF BURTON W MCINTIRE a SAVINGS
SSN 213-38-0563 ^ CHECKING
C~.-~~~ :r DATE OF DEATH 01-02-2011 ^ TRUST
L, F C' 7`"'~ CERTIF.
Or~~f i,"'r'~'-"~IJi.1RTr COUNTY CUMBERLAND
C~,~~~i'r'_'~t''~ i f~hl r'A. REMIT PAYMENT AND FORMS T0:
BOPHA T MCINTIRE REGISTER OF WILLS
318 BEVERLY RD 1 COURTHOUSE SQUARE
CAMP HILL PA 17011-2813 CARLISLE PA 17013
P SECU 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 Ill-787-832? with questions.
COMPLETE PART 1 BELDW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0213380563 Date 05-12-1999 To ensure proper credit to the account, two
Established copies of tflis notice must accompany
payment to t:he Register of Wills. Make check
Account Balance $ 3,517.67 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If t(ix payments are made within three
Amount Subject to TaX $ 586.29 months of the decedent's date of death,
Tax Rate ~( , 00 deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential TaX Due $ ~~ nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
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 and
C H E C K an official assessment will be issued by the PA Department of Revenue.
C ONE
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 ~ and/or PART ~ below.
PART If indicating a different tax rate, Please state
relationship to decedent:
TAX RETURN - CALCULATION OF TAX ON JcIINT/TRUST ACCOUNTS
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
1
2 _ _
$
3 X
4 $
5
6 '~
7 X
8 $
PAD
OFFICIAL USE ONLY U AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
nnTr pern PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I
complete~to thlg bes/t///of my knowledge and belief.
nn~l~ I In /A~~.I4~1 /J1. ~ ~ ~~
R S
reported above are true, correct and
HOME C~ l~ ) s ~ 1
WORK C~7 1~1 ) •~ <J_C1 ~ C~ ~ ~ IO l(~I 1 ~
TELEPHONE NUMBER DATE
IUIHL \CnLBI- uil Lin< ~ v~ i w ~ ~-- -••-
''~~
,.~
~~~ `' ~
,~;
~'' '.:
;~
~,, `'~:
~'~
v.
~ ~,
t~,
~ ~.~
~ _
ou - ~ U
~~ ~ ~
v ~` `f ~ '_
~,
_- ~ ~_
~--
0 0
.-,
~- .-/~4-- °~
q~ ~ ~ ~
.--~-- ~ f
~- v
~~ v
^ / ~1
C\` J/
~~~
~~ i{{
t t
~~
•~ ~
•~'~E
C I
L
L ~
V ~
r
~ ~_ III
O ~ =
meal
~_ ~ ~ .
~i,U
O