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HomeMy WebLinkAbout12-28-11 (2)~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0564 BUREAU OF INDIVIDUAL TAXES -'' Po Box zso6ol perc~sylvania l~ AND ACN 11179005 HARRISBURG PA 17128-0601 DEPARTMENT AF REVENUE ~ TAX P AY E R R E S P O N S E DATE 11-30-2011 REV-1543'EX RFP (65-11) ~~ ~ ~~ 1 --, ~ ~ 1 e ..~ .,dt ,, C'~U~-- _ .PA ~~. LOUISE DONIVAN 116 W HILLCREST DR CARLISLE PA 17013-1215 EST. OF ROYAL S DONIVAN SSN 160-20-2591 DATE OF DEATH 05-04-2011 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 tax due. Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. If y0U 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 * S66~REVER-SE°SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0591134373 Date 10-21-2008 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 $ 1 ~ 176 • 19 Payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three AmOUnt Subject to Tax g 196.04 months of the decedent's date of death, Tax Rate X 15 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential TaX Due $ 29 • 41 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 a discount or avoid interest, or return this notice to the Register of Wills and C H E C K an official assessment will be issued by the PA Department of Revenue. ONE C 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 filed by the estate representative. C. The above informs ion is incorrect and/or debts and deductions were paid. PART ~ below d/ T ~ omplete . or an PAR PART If indicating a different tax rate,.-please to relationship to decedent: bn~n ~~` TAX RETURN - CALCULATION OF TAX ON JOINT/K~~TaaRUST ACCOUNTS LINE I. Date Established 1 ~ V 2. Account Balance 2 $ ,~j ~ •~~~ S 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PAD OFFICIAL USE ONLY u AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 PART neTF peTn PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. ~~~ /~ •_ YER SIGNATURE DEBTS AND DEDUCTIONS CLAIMED reported above are true, correct and HOME C 'f ~ I ) ~ ~~ - 7 7~~~ WORK c ~r~ ~ X47•- ~'73G 1~-/!~- l TELEPHONE NUMBER DATE iu(s~~ fencer un amine ~ ..~ - - ti J }"' i __ >,ia 9 `~ 1 ~ >. r } (~ 1 j ? _ ~~~ ~~ ,.~ .. 4.~?- ~~ ~,i; F~. a}~ _' t 9 1 a J 4 Y, N y i y a i 4 5M ~(\ Al ^ 1 J^l ~ 1 ~~ ~1, <;~ S~ ~ ~~ ;~ -~ ~ ~ ,~ .'~ ..~ 1' ~~ \~ i A~ .sue ~ ~~ \1 v ;~ '~ ~_\ N ~ \ ~` A v , © ~ `J y r -., s_ ~~ ~~ t,•~ ;~E ~ °f ~i) `'f') ! °~ •'fi 3 ~~f i~^' ~r+