HomeMy WebLinkAbout12-16-11 (3)" -~- ~ "" PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES ~ AND FILE N0. 21' ~~' ,~
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Po cox zeasol T'' r' YER RESPQNSE ACN 1112389
HARRISlUR6 PA 17125-0601 J~'~ ~ j +-` ~:~f t~
~' ;~;~,,'" y~ DATE 04-07-2011
REY-15{3 E% AF/ (~~~~~ ~ 4 ~ .{y i7 ~'
LEI J ~~~ 16 TYPE OF ACCOUNT
P~ 3; 2 5 ssT ~ -..~
® SAVINGS
SSN 524-40-34.34 Q CHECKING;
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CLfRK { DATE OF DEATH 12-02-2010 ^ TRUST
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^!QRPF~j`S u
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} Q(~~j COUNTY CUMBERLAND ~ CERTIF.
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~~~(~~~IJ.'~' (',("`} ~jA REMIT PAYMENT AND FORMS TOe
HENRY E MOWERS REGISTER OF WILLS
1860. HUNTER DR 1 COURTHOUSE SQUARE
MECHANICSBURG PA 17050-1605 CARLISLE PA 17013
WACHOVIA BK, NA provided tho Dapartunt with the inforaati4n below, which has boon used in calculating tM
potential tax~due. Records indicate that st the death of the above-naaed decedent, you wero a ioint ownerlb~mfioisiy of this account
If you faoT t6a infor~ation is incorroet, please obtain written correction frog tM financial institution, sttaeA'a copy #o this forty
and return it to the-aboV~ addross. This account is taxable in accordance with the Tnheritence Tax laws of the Coeaonwealth of
Pennsylvania. Pluse call C717) 7g7-5327 with questlons.
COMPLETE P'-ART 1 -BELOW r SEE REVE~ISE SIDE F012~ FILING ANI~ PAYMENT INSTRUCTIONS
Account No. Date 02-17-19$1 To ensure prover credit to the-acconnt, two
Established copies of this noticr ausE aeeoapatar
Account Balance 7,691.55 payeent to the"Register of wills: Make eMck
payable to Register of Wi11s, Aydnt .
Portent Taxable
As:ount Subject to Tax
Tax Rat•
Potential Tax Du•
PART
X 16,667..
$ 1,281.95
X .15
S ,..19.2.29:..
NOTE: If tax vayaenta are aad~ within three
aonths of the daeed~nt's.dat• of d~Eri°
deduct a 5 percent discoupt on the aax duo.
Any Inheritance Tsoc dw .Mill b.ao.."a.Iinqunt
nine aonths afNr tM date of death..
A. ~ The above intonation snd tax duo is eorrect.~
Rnit payunt to th, Ryq,~st~~.ofFy!#}],~s„with two eopias of this notice to obtain
CHECK a diseognt dt avoid intaros~; o"r" 5heek box ,°A• and "return this notice to the Ropistfr of
ONE wills snd an official sssassaen't will be isswd by the PA Wpartaant of Revenue.
BLOC K ] B. The above asset has bean 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 fnfors~tion is inearr~ and/or debts and deductions wore paid.
Cwvlet• PART' 2 and/er PART 3 below. _
PART If lndicatinq a different tax ra-t,,a,,~]y as• toQN"L~
relationship to deoedent: s`ue' """~T- ~"~
TAX RETURN - COMPUTATION OF TAX-OM JOINT/TRgST ACCOUNTS
_ - - LLME_ 1:-DatA- Established' _ - t--- -d ~-`t ~-`_ - .[-._ - __.". ...
2. Account Balinco 2 ~ "7fi ~ ;SS
3. Pbrcant Taxable 3 X ~ ~Q
4. Aeount Subject to Tax 4 $ ~'b
5. Debts and Deductions 5
6. Amount Taxable 6 ~ L
7. Tax, Rata 7 X ~~,
8. Tax Du• 8 ~ ~a 0~ -.
PART DEBTS AND DEDttCTI0N3~ CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID'
Under panel es Of •riurlt-;I al#r• that the facts i have raportad above arp true~,cxsrrryt,snd
comps. a d h~"~' HOME C ) ~` _ t
AX, YER UR WTELEPH NE N 1 B R .~ ~ ~ ~-