HomeMy WebLinkAbout10-26-11BUREAU OF INDIVIDUAL TAXES
PO BOX 2B0601^^,~ -• .
HARRISBURG P/X'~f},7128-0601
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pegliisylvania
DEPAWTMENT OF REVENUE
-REV 11543 EX AFP (05-11)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 -~~-"~~
AND ACN 11166735
TAXPAYER RESPONSE DATE 10-10-2011
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REETA OTTO
106 SUNSET DR
NEW CUMBERLAND PA 17070-3059
EST. OF GEORGE R OTTO
SSN 197-24-3060
DATE OF DEATH 09-01-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
CITIZENS BANK OF PENNSYLVANIA 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 Sp0U5e 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 farm 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. 6100770214 Date 01-26-1981 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 3 ~ 571.88 payment to the Register of Wills. Make check
$ payable to "Reg:ister of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $` 1 , 785.94 months of the decedent's date of death,
Tax Rate ~( lrj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 267.89 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICiAI.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
C H E C K 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 Revenue.
C ONE
B L 0 C K B. ~ The above asset has been or will be repor ted and tax Daid with the Pennsylvania inheritance tax return
0 N L Y filed by the estate representative.
C. ~I The above informs ion is incorrect and/or
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PART ~2
d/
PART ~ b
l debts and deductions were paid.
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ow.
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. Date Established 1 1
2. Account Balance 2 $ 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 $ ~ $
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I
comple~8, to the best oaf-}m-y knowledge and belief.
reported above are true, correct and
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TELEPHONE NUMBER DATE
TOTAL CEnter on Line 5 of Tax Computation) S