HomeMy WebLinkAbout01-04-12PENNSYLVANIA INHERITANCE TAX
`r ~ ~ INFORMATION NOTICE
,F (Jli' FILE N0. 21 ~~--~'
BUREAU OF INDIVIDUAL TAXES
PD Box zaocol - ~ A N D
Pennsylvania _,; ACN 11184650
HARRISBURG PA 17128-0601 DEPARTMENTOFREVENUE TAXPAYER RESPONSE DATE 12-28-2011
REV-1543 E% AFP (05-11)
- " . ~' r' ~` '~ ` TYPE OF ACCOUNT
r,_ EST. OF RUTH H KNOX ~ SAVINGS
~
~~( E' SSN 002-28-8592 ~ CHECKING
, ,., DATE OF DEATH o6-26-2011 ~ TRUST
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' COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
DOUGLAS M KNOX REGISTER OF WILLS
24 ELM TREE CIR 1 COURTHOUSE SQUARE
NEWVILLE PA 17241-9491 CARLISLE PA 17013
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 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 )s 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 FDR FILING AND PAYMENT INSTRUCTIONS
Account No. 1715442495 Date 06-26-2003 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 $ 3, 074.50 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $` 1,537.25 months of the decedent's date of death,
Tax Rate ~( lrj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 230.59 nine months after the date of death.
PaRT TAXPAYER RESPONSE
FAILURE TO RESPOI'ID WIL°L RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ^ The above information and tau 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 paid with the Pennsylvania inheritance tax return
D N L Y filed by the estate representative.
C. The above informs ion is incorrect and/or debts and deductions were paid.
omplete PART ~2 and/or PART 3^ below.
PART If indicating a different tax rate, please state
relationship to decedent: SCc+`-'~-Sr
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
3 X
4 $ ~r-~ ~C ~ ~~
5
6 $
7 X
g $ rC3 .~
PAD
OFFICIAL USE DNLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of my knowledge and belief. HOME C~ ~Z ) ~~f- `e$tf`j?
17 t~ ~/Y"'cr't WORK C ) Z~ ~~
TAXPAYER SIGN URE
TELEPHONE
NUMBER
DATE
~
TOTAL CEnter on Line 5 of Tax Computation) S
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