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HomeMy WebLinkAbout12-30-11BUREAU OF INDIVIDUAL TAXES ... _ PO BOX 280601 HARRISBURG PA 17128-0601 I _, NEV-1543 EX AFP (OB-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~~~ AND TAXPAYER RESPONSE FILE N0. 21 10-1146 ACN 11100645 DATE 01-05-2011 1 lit... ~. ti~„j ~ t•i ~. 1n I ~ i )-,- . , GARRETT F PUNCH III 41 PALMER DR CAMP HILL PA 17011 EST. OF JOSEPH M PUNCH SSN 206-32-0771 DATE OF DEATH 11-01-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. M & T BANK provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a Joint owner/beneficiary of this account If you feel 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. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pannsyl van4a. Piea~e call :717: 787-8327 with questia~s. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 14252090 Date 08-28-1985 To ensure proper credit to the account, two Established copies of this notice must accompany $ 7 3 0 . 8 4 payment to the Register of Wills. Make check Account Balance payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 365.42 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate ~( 12 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 43.85 nine months after the date of death. PART TAXPAYER RESPONSE It~11RE O R ON WI StTL.~'' fN At~1 ~ Ill{.. T S SSM 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 check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K ~ B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y ~to be 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 ~ {~ ICIAi. US5 QNL AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD _ LINE 1. Date Established 1 1 - ` 2. Account Balance 2 $ Z 3. Percent Taxable 3 X ~ 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable (, $ 6 -~ 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMniiNr porn Under penalties of perjury, I declare that the facts I have reported above are true, correct and ~~~mplete to the best of my/knowledge and belief. HOME C 1 ' ~ / WORK C~~7 ~ ~37- O j~p PAYER SIGNATURE TELEPHONE NUMBER DATE ~w:.+~ Fencer on u.ne s of lax Computation) g