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Home My WebLink About12-16-11 (4),r ~ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17126-0601 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE 1~~~'f ~~ ~'~,~ AND MENf~QF~j~I,EN,NE,.i , ,, ,,, ~AXPAYER RESPONSE REV-1543 ter f i ~~ I b P~ ~~ 3 ti GLERK ~~ ORPHAN`S BURT GtIMP~~! ~h~~ t;~ Pq JOAN L MOWERS 1860 HUNTERS DR MECHANICSBURG PA 17050 EST. OF FILE N0. 21 11-0493 ACN 11150317 DATE 07-28-2011 SSN 162-22-0139. DATE OF DEATH `04-05-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS'T0: REGISTER OF .WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS .CHECKING TRUST CERTIF. WELLS FARGO 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 ere 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 1n 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~bov_g_address.__pl,e~se_ca71 717-787-8327 with questions,_. _____~__ ____ _.-_ _ ~ __ COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3061980551 563 Date 02-01 -1981 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 159. 14 payable to "Register of Wills, Agent". Percent Taxable X 8. 333 NOTE: If tax payments are made within three Amount Subject to Tax $ 13. 26 months of the de~edent•s date of death. Tax Rate X , 1~j deduct a 5 percont discount an the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 1 . 9 9 nine months after the date of death. PART CHECK ONE BLOCK ONLY A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return his notice to the Resister of Wills. and an official assessment will be issued by the PA Department of Revenue. B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate representative. C. ~ The above infona ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different ~ a e, le relationship to decedent: ~ TAX RETURN - CALCULATION LINE 1. Dste 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 PART DATE PAID PAYEE ~/0 DESCRIPTION AMOUNT PAID WORK t ) TOTAL (Enter on Line 5 of lax Computation) i Under penalties of periury, I declare that the facts I reported above aro true, torte t an y/~. com-liate to the best of my knowledge. and belief . HOME C`I~7 ) / i'7sf-~~~ ~(/