HomeMy WebLinkAbout01-27-12BUREAU OF INDIYIDWL TAXES
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HARRISBURG PA 17126-0601 DEPARTMENT OFREVENiI
MEV-1563 EX AFP (a3-1
PENNSYL~VAQNIA INHERITANCE TAX
I~I^~- AND NOTICE FILE No. 21--1~ ~ ~U
' ACN 11181098
~}~~ ~ER RESPONSE DATE 12-13-2011
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EST. OF DOUGLAS B THOMPSON
~,C~ SSN 198-3D-0106
35 ~~TD~ATE OF DEATH 05-27-2011
~{~ UNTY CUMBERLAND
-~"'' ~~~~ REMIT PAYMENT AND FORMS TD:
CAROLYN D THOMPSON RE ISTER OF WILLS
140 PARTRIDGE CIR 1 COURTHOUSE SQUARE
CARLISLE PA 17013-8701 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 ,mint owner/beneficiary of this account. If yoU are the SpgUSe Of the
deceased and any amount other than zero 1s reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your.relationshlp to the deceased by checking Box C 1n PART 1 below and writing "spouse" 1n PART 2.
If you believe the information is incorrect, please obtain written correction from the financial insti tuff on. attach a coDY 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. 2891040341 Date 05-06-1999 To ensure vroper credit to the account, two
Established copies of this notice oust accompany
ACCOUnt Halince 5~6 6.6 7 oavment 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 g 283.34 months of the decedent's data of death.
Tax Rate ~( ~ 1 rj deduct a 5 percent discount on the tax duo.
4 2.5 D Aro inheritance tax duo will become delineuent
Potential Tax Due s nine months after the date of death.
P~T TAXPAYER RESPONSE
7
A. ~ The above information-and taz duo is correct.
Remit payment to the Rapister of Wills with twocopies of this notice to obtain
CHECK a discount or avoid intarest,'ar return this-notice to the Register of Wills and
0 NE an official assessment will be issued by the PA Department of Revenue.
BLOCK B. ~ The above asset has Dean or will be reported and tax paid with the Pennsylvania inheritance tax return
ONLY filed by the estate representative.
C. ~aL~ Tha above infer a ion is incorr ct and/or debts and deductions were paid.
J-~ Coapleta PART ~ and/
r PART 3~ b
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ow.
PART If indicating a different sa state
tax rat~/ Cp a
relationship to deeadant: ~
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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 Subioet to Tax 4 ~
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Du• 8
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
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