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Home My WebLink About01-18-12PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE Y ~ BUREAU OF INDIVIDUAL TAXES ~ FILE ND. 21 _ ~_f~J Po Box zao6ol ennsyLVdn17 AND HARRISBURG PA 17128-0601 ~ r - ACN 12100998 oEPARTMENTOFRE4Eti~E_ TAXPAYER RESPONSE DATE 01-05-2012 REV-1543 EX AFP (OS-ll) VIOLET M FRAKER 301 EASY RD CARLISLE PA 17013-9585 EST. OF CHARLES J FRAKER SSN 162-22-3525 DATE OF DEATH 07-07-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SO VEREIG N 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 t_he department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you be ieve the information is 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 ~ SECAR[VERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2891039491 Date 05-29-1998 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 2 106.57 payment to the Register of Wills. Make check ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to TaX y` 1 , 053.29 months of the decedent's date of death, Tax Rate ~( 1Fj deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential TaX Due g 157.99 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 C H E C K _ a discount or avoid interest, or return this notice to the Register of Wills and C -' an official assessment will be issued by the PA Department of Revenue. ONE ' BLOC K i B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return O N L Y filed by the estate representative. C. The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax ~f~drl~~~state OFFICIAL USE ONLY ~ AAF relationship to decedent: o f~ Tyr'-' ^D ~~ PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 +fi 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 ~j 6. Amount Taxable 6 '~ (, 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 5 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 ~ ~ 7 ) Z. ~~ ''[~j ~!.CZT'C~~' 7"a't ~./~C~-eit._ WORK C ~ - / ~ - I Z~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE 1"r ~` >~I.~-., a. # 1. (~ `: 1, ?< a ~ ~ : ~s 7 f$ r _ 1 ~_ :: r i :. ~ ~\ r L1~ ~ , ' \~ ~ ~ .... 3r ~ ~ t l ~ '` ~ ~ ~ ~ V^'^ ~ / ~" ~~ ~~/ --~ \~:/ r\ n ( +y, ~ ` "", • ~~ `~ ,'/ 1 u~( J J ^ ~(/) "J l Ji v -~ ._.i:I tv 1 {~.~ ail ~S1 t;f it 2 3.:~i .~..t