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HomeMy WebLinkAbout12-16-11BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 Pennsylvania DEPARTMENT DF REVENUE REV-1543 E% AFP (05 -11) PENNSYLVANIA INHERITANCE TAX I'ffs~ INFORMATION NOTICE FILE N0. 21'1 ~' 13`T~ AND ACN 11180917 TAXPAYER RESPONSE DATE 12-12-2011 PEGGY A TH~2AN 18 CIRCLE DR MECHANICSBURG I PA 17055-6139 EST. OF ROBERT L THRAN SSN 208-24-4019 DATE OF DEATH 11-20-2011 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 PENNSYLV NIA provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the deat of the above-named decedent, you were a joint owner/beneficiary of this account. If y0U are the Sp0U5e Of the deceased and any amount othe than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of you 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 all 717-787-8327 with questions. COMPLETE PART 1 B LOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 610076448b Account Balance Percent Taxable Amount Subject to Ta Tax Rate Potential Tax Due Date 11-18-1974 Established $ 5,118.56 X 50.000 $ 2,559.28 X .15 $ 383.89 To ensure proper credit to the account, two copies of this notice ^ust accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. P~T TAXPAYER RESPONSE ~ ItURE O LL RESULT IN AN 10 FICIAL TAX... A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to ~~ a discount er avoid interest. or return this nntiee to the Resister of W ;? TMj - _, n ~i I-- _ -- i.n et,n ' an official assessment will be issued by the PA Department of Revenue. </j h S'' ~ ONE B L 0 C K B. The above asset has been or will be reported and tax paid with the Pennsylvania ~_~(^~ ce t~return ~~~ ~ ONLY filed by the estate representative. " ,. i ~.:.. C. The above informs ion is incorrect and/or debts and deductions were paid. "4ry ~,~ ~ r'.J -- PART ~ below l t PART ~2 d/ - C , . omp e e an or : r 4Ll' PART If indicating a ifferent tax ra~w,,,p~ea~g/ytate " Q I}IjL 1)S O AAF relationship to ecedent: 7f~(J[/~~~' pA DEPAi?T~i>~NT OF NUE TAX RETURN - CALCULA TION OF TAX ON JOINT/TRUST ACCOUNTS AD LINE 1. Date Established I 1 1 ~ ~~ 2. Account Balance 2 $ 2 3. Percent Taxable 3 X ~_' _ 4. Amount Subject to Tax 4 $ Cr ...._ 5. Debts and Deducti ons 5 S 6. Amount Taxable ~, 6 $ b 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED ~ a DATE PAID PAYEE DESCRIPTION AMOUNT PAID rorAL cEnter on Line s or iax t;omputation) s Under penalties of pelNjury, I declare that the facts I reported above are true~,7/co/rrect a~n/d complete to the bestbf my knowledge and belief . HOME C7~ 7 ) /y cr e~ 7 t"~ n~T,-_WI`~--- WORK C ) TAXPAYERd~ NATURE TELEPHONE NUMBER ~~ AT ~! _. __