HomeMy WebLinkAbout02-07-12~~ PENNSYLVANIA INHERITANCE TAX
~~~~ INFORMATION NOTICE FILE N0. 21 «.-1~~?
BUREAU OF INDIVIDUAL TAXES
Po Box zao6ol PenC~~~~ , + r ;~ AND ACN 12108369
HARRISBURG PA 17128-0601 pEPAR,+MN~Of1= EVERU~ ~ ' ~L~+~~ TAXPAYER RESPONSE DATE 02-06-2012
REV-154~A5P_, c1~iiS '. ~; •: ~'J
TYPE OF ACCOUNT
L~ ~ ~ ~ ~$ -7 ~ ~ 1 ~ ~ ~ EST. OF CAROL A FABIAN ^ SAVINGS
SSN 169-44-5534 ~ CHECKING
~~~~~ (1t~ DATE OF DEATH 09-23-2011 ~ TRUST
Q~i~HA~~~ [:t`;;,i~T COUNTY CUMBERLAND ~ CERTIF.
Cl1~RF~?i_~~I'~' ~ ,L d FA REMIT PAYMENT AND FORMS T0:
GEORGE E FABIAN VII~V~ REGISTER OF WILLS
360 MELS LN 1 COURTHOUSE SQUARE
HARRISBURG PA 17112-8433 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 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 * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0461070987 Date 04-21 - 1999 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 $ 905.32 payable to "Resister of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 452.66 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 $ 67 • 90 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.
C ONE
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.
Complete PART 2~ and/or PART 31_I below.
PART If indicating a different tax rate, please state
relationship to decedent: ~ ~ ~~~ ~
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
1
2 $
3 X
4 $
5
6 `~
7 X
8 $
PAD
OFFICIAL USE ONLY U AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
0
IUTAL fencer u„ ~ii,r ,,.r...o.+~••~ -
Under pen ies of perjury, I declare that the facts I reported above areytrue,.cco~rlrect a~nyyd ~
complet o the bes /~~e and belief. HOME C ~~/ ) rJ / ~ ~;D/~ ,~~
-.,~_L~ W O R K
TAXP ER GNATURE TELEPHONE NUMBER DATE ,,
neTF Pain PAYEE DESCRIPTION AMOUNT PAID
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