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HomeMy WebLinkAbout12-28-11~~_ BUREAU OF INDIVIDUAL TAXES PD BOX 266661 D~Q~m~xlva~~ HARRISBURG PA 17128-0601 ~~rc~~ff11 DEP14itTMENT OF REVENUE REV"i 1T~43~EX'AFR-(05 =11) PENNSYLVANIA INHERITANCE T INFORMATION NOTICE /~~- C~ AND '''' `` TAXPAYER RESPONSE J FILE N0. 21 .f~,_~'J~~ ACN 11181643 DATE 12-15-2011 t-, r. `' ,~ l} ~L~ ~. `LF~~~ ~~(l~,I~.r L L CAPARELL}Ar 309 E MARBLE ST MECHANICSBURG PA 17055-4264 EST. OF ALEX J CAPARELLA SSN 201-32-9266 DATE OF DEATH o4-16-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS © CHECKING TRUST CERTIF. SOVEREIGN BANK provided the department with the information below, which was used in calculating the inheritance taz 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 717-787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1681730251 Date 02-24-2003 To ensure proper credit to the account, two Established copies of this notice must accompany ACCOUnt Balance $ 4,718.87 payment to the Register of Wills. Make check Percent Taxable payable to "Register of Wills, Agent". X 50.000 Amount Subject to TaX $` 2, 359.44 NOTE: If tax payments are made within three Tax Rate months of the decedent's date of death, X . 1 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 353.92 Any inheritance tax due will become delinquent 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 C H E C K 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. ~ The above asset has been or will be reported and tax 0 N L Y paid with the Pennsylvania inheritance tax return filed by the estate representative. S ~~' /)~ C. The above informs ion is incorrect and/or debts and deductions were paid. ~ i 11 (Vl (z Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: OFFICIAL USE ONLY (~ AAF TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD PA DEPARTMENT OF REVENUE LINE 1. Date Established 1 2. Account Balance 2 $ 1 3. Percent Taxable 3 X Z 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 $ 5 6. Amount Taxable 6 6 7. Tax Rate ~ X 7 8. Tax Due g $ 8 PART ^ DEBTS AND DEDUCTIONS CLAIMED 3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I reported above are true, cprrect and co plet o the best of myy k~ ge and belief. p~ /J / ~ ` ~ n ^ ' HOME ( /~~~ / ~i ~,(~ 4~~ TAXPAYER SIGNATU E (~ TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 p sy~Vania DEP~A TNYEk? O~ REVENUE REV-;T543.. EX AFP (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ;C ~r AND FILE N0. 21 -II'~:?~7(1 TAXPAYER RESPONSE ACN 11181643 7 ``~ DATE '-'.~ 12-15-2011 ~;~ ~~ ~ J4 C.l C~`~ ; L L CAPARELLA 309 E MARBLE ST MECHANICSBURG PA 17055-4264 EST. OF ALEX J CAPARELLA SSN 201-32-9266 DATE OF DEATH 04-16-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS XO CHECKING TRUST CERTIF. SOVEREIGN BANK 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. 1681730251 Date 02-24-2003 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 4 ~ 718.87 payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". 50.000 Amount Subject to TaX ~` 2, 359.44 NOTE: If tax payments are made within three Tax Rate months of the decedent's date of death, X . 1 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 353.92 Any inheritance tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. The above - f in ormation and tax due is correct. C H Remit payment to the Register a disc t of Wills with two copies of this notice to obtai E C K oun or avoid interest, or return this notice to the n R i C 0 N E an official assessment will be issued by the PA Depart t eg ster of Wills and B L 0 C K 0 N L Y ~ B. ~ The above asset has been or will b e reported and men tax Paid with of Revenue. t filed by the estate representative . he Pennsylvania inheritance tax return C• ~he ab Comp ove information is incorrect lete PART and/or debts and deductions were paid ~2 and/or PART 3^ below. . peoT if .,~;.. ~«;.. --------- irren~ iaX rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percen± 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 1 2 +fi a X 4 5 - 6 7 X 8 OFFICIAL USE ONLY [~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 4 5 6 7 8 .0 DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I reported above are true, correct and ~mple to the est oaf/1emy knowledge and belief. HOME (7~~ ~ ,~. ~ ~- ~y~/~ TAXP YER SIGNAT E -' TELEPHONE NUMBER DATE _~~ b ,~. ':~'~; _ - , !: F ..'f i ~Er O~F~- ~ ~ ;;-. ~, PA ~~ ~a 9 ..~ ~4~ ~~~ ~~ }'~ i.y~t y~f .~r•) 3~. } .,. ~~~