The URL can be used to link to this page

Home My WebLink About01-17-12BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 .~ ~,: Per~isylvani~ DEPARTMENT OF REVEN UE REV-1543 E% pFP (OS-11 ) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE "~t AND FILE ~~ ;~ TAXPAYER RESPONSE ACN '" '' DATE i -r ~ t"., EST. OF BETTY J LACKEY (;E C~i~ - SSN 235-38-3815 ~ 1 , ,. r DATE OF DEATH 07-05-2011 G'I `i ' ~ ! ~ ~`':-,n COUNTY CUMBERLAND '`` REMIT PAYMENT AND FORMS TD: WILLIAM H LACKEY 35 LONGVIEW DR REGISTER OF WILLS MECHANICSBURG PA 17050-2722 1 COURTHOUSE SQUARE CARLISLE PA 17013 N0. 21 11-0771 12100919 01-05-2012 TYPE OF ACCOUNT SAVINGS O CHECKING TRUST CERTIF. SOVEREIGN BANK Records indicate that at the death of the above named decedent, you were a provided the department with the information below, which was used in calculating the inheritance tax due. notify the department of 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 your relationship to the deceased b checkin Box C in PART 1 below and writin it to the above address. Please call 717-787-8327 with y 9 you must If you believe the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return questions. 9 spouse" in PART 2. COMPLETE PART 1 BELOMi * SEE REVERSE SIDE FOR FILING AND PAYMENT I,'~STRUCTIONS Account No. 1681722089 Date 04-07-1998 Established To ensure proper credit to the account, two Account Balance copies of this notice must accompany $ 5 ~ 807. (2 Payment to the Register of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 50.000 $ 2, 903. $1 NOTE: If tax payments are made within three Tax Rate X months of the decedent's date of death, Potential Tax Due • 15 deduct a 5 percent discount on the tax due. $ 4 35.5 7 Anv inheritance tax due will become delinquent PART nine months after the date of death. 10 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 C C H E C K a discount or avoid interest, or return this notice to the Register of Wills and 0 N E ~ an official assessment will be issued b v the PA Department of Revenue. B L 0 C K B. ® The above asset has been or will be reported and tax 0 N L Y filed by the estate representative. Paid with the Pennsylvania inheritance tax return C• ~ The above informs ion is incorrrrec~~t and/or debts and deductions were Complete PART ~ and/or PART ~a ~ below. Paid. PART If lndicatine ~ a;ca____~ (~~~JJJ u relationship to decedent ~dx race, please state TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 +fi 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate X 8. Tax Due PART 7 8 $ 1 2 ~,_ 3 4 5 6 7 ~_ B liEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties c of perjury, I declare that the fact I $ omplete to the s best of my knowledge and belief reported above are true, correct and ` ~ . ~ir~c~rs1~ HOME C 7r 7) 69/-7vtu~ TAXPAYER SIGNA R WORK C ~ TELEPHONE NUMBER r r7 ~~ ner~ OFFICIAL USE DNLY ~ AAF PA DEPARTMENT OF REVENUE PAD