HomeMy WebLinkAbout01-27-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES
PO BOX 280681 AND
HARRISBURG PA 1712E-0601 TAXPAYER RESPONSE
FILE N0. 21 ~~ ~~~~
ACN 12500185
DATE 01-24-2012
REV-1543A AFP (7-00)
TYPE OF ACCOUNT
EST. OF WALTER F; SOWERS ® SECURITY
S.S. N0. 182-46-3970 ^ sEC ACCT
DATE OF DEATH 12-13-2011 ^ STOCK
COUNTY CUMBERLAND ^ BDNDs
REMIT PAYMENT AND FORMS T0:
MARY C SOWERS REGISTER OF WILLS
3069 SPRING RD 1 COURTHOUSE SQUARE
CARLISLE PA 17013-8713 CARLISLE PA 17013
CAP7IAL BANK & TRUST has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset.
If you feel this information is incorrect, please obtain written correction from the transfer agent, attach a copy to this fors and
return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Cosmonwealth of Pennsylvania.
Questions say be answered by calling C717) 787-6327.
COMPLETE PART 1 BELOW * ~ * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 62741250
To insure prover credit to your account, two
C2) copies of this notice must accompany your
DOD Valuation 11 ~ 798 .82 payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
Percent Taxable X 100 .00
Amount Subject to Tax
11
798
82 NOTE: If tax payments are made within three
~ . (3) months of the decedent's date of death,
Tax Rate X , 00 you may deduct a 5Y. discount of the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due • 00 i
n
ne C9) months after the date of death.
PART TAXPAYER RESPONSE
^ ..'.'~ti•r.r i~ar Jt""r..fC'{iY~~w.`._:'_A .. 3c.> ._ •HC 1. i.: .' ..~K.. - _.
A. ~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check box "A" and return this no ce to the Regi,~t er of
ONE Wills and an official assessment will be issued by the PA Department of R~nue. ~_
BLOC K ~
g, ^ The np
above asset has been or will be reported and tax paid with the Penns
lvan~
it
0 N L Y
to
be filed by the decedent's representative. y
er
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C. ^ The
above information is incorrect and/or debts and
deductions were paid by
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You Bust complete PART ~ and/or PART ^3 below. C;rj~ V ~~.j t T'i
PART If you indicate a different tax rate, please state your ~~
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~ E ~~Y -
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,
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relationship to decedent: ,
PA bE~'A y
~t~ C1F~£VE
TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS) ~D'~
LINE I. DOD Valuation 1 1 '
2. Percent Taxable 2 X ~~
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3- Amount Subject to Tax 3 ~ ~ ~,
4. Debts and Deductions 4 -
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~ ,~
5. Amount Taxable 5 _
5
6. Tax Rate 6 X 6 •
7. Tax Due ~
PART
DATE PAID PAYEE
7 ~
~ $
DEBTS AND DEDUCTIONS CLAIMED
AMOUNT PAID
DESCRIPTION
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my know ge and belief. HOME Cam]/7 )
WO R K C ~( ) ~ _- 07
TAXPAYE IGN URE TELEPHONE NUMBER G /~/ DATE
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~F77CCC~?l~~~i~ ~~~ (O+F
2Qi2 JAN 2? AH f i ~ 56
CLERK OF
ORPHAN'S COURT
Cl1MBERl~SJlI CQ., PA
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