HomeMy WebLinkAbout10-21-11 (2)~~ PENNSYLVANIA INHERITANCE TAX ii ii-~~^^
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES ;"~~ ;,,~ FILE N0. 21
Po Box zaosol pennsyl .erna , '~~ ~. AND ACN 11166831
HARRISBURG PA 17126-0601 OEPARTMENTO~`flEYF{MUE _ ,',~-XP AY E R R E S P O N S E
_ DATE 10-10-2011
REV-1543 EX AFP (05 -11) - - ;, .J
L ^(I ~ v
j~i' P~
EST. OF ELIZABETH V SWINGLE
SSN 205-09-9634
DATE OF DEATH o9-13-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
CAROL A SELCHER REGISTER OF WILLS
720 SPRING GARDEN DR 1 COURTHOUSE SQUARE
MIDDLETOWN PA 17057-3034 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA 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 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. 5004893574 Date 10-13-2006 To ensure proper credit to the account, two
Established copies of this notice must accompany
AcCOUnt Balance $ 12,407.UU Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
6 ~ 203.50 NOTE: If tax payments are made within three
Amount Subject to Tax months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
2 7 9 . 1 6 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
CHECK a discount or avoid interest, or return this notice to the Register of Wills and
C 0 N E ~ ~ an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. he 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
relationship to decedent:
TAX RETURN - CALCULATION
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
OF TAX ON JOINT/TRUST ACCOUNTS
I
2 $
3 X
4 $
5
6
~ X
8 $
PAD
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above ar/e~true, correct and / `_.'/'I~(
complete to the bes/tyof my,/kn-o/w,ledg/e and belief. HOME ( / / ) ~ ,3~J / Jvv"
C~~ C.C ~ ~J ~f'~~TL~~ WO R K ( ) ~O ~~~ ~
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
DEBTS AND DEDUCTIONS CLAIMED
TOTAL (Enter on Line 5 of Tax Computation) S ,