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Home My WebLink About02-16-12PENNSYLVANIA INHERITANCE INFORMATION NOTICE BUREAU OF INDIVIDUAL T/~$;/ ~~,~ ( ,` ;a AND PO BOX 280601 i~'SSCC ~S HARRISBURG PA 17128-0601,•-;, ~Epp~p,EN..tj, y NUE TAXPAYER RESPONSE wREV-1543 E% AFP (OS-11) TAXI FILE N0. 21 - ~ ~ - ~, ACN 12110803 DATE 02-15-2012 c~ti2 FHB 16 ~~ ~-' 26 GI.ERK OF ~ y~~ ~~ C'~ jPA t~t~„''~ ALMA M REYNOLDS 1015 DREXEL HILLS BLVD NEW CUMBERLAND PA 17070-1737 EST. OF CLARK B REYNOLDS SSN 179-18-3701 DATE OF DEATH 09-21-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE 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 joint owner/beneficiary of this account. If yoD 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 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 INSTR:lCTIONS -- Account No. 2334086975 Date 01-22-2010 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 $ 51 , 967.08 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 25,983.54 months of the decedent's date of death, Tax Rate ~( 1j deduct a 5 percent discount on the tax due. Anv inheritance tax due will become delinquent Potential Tax Due $ 3,897.53 nine months after the date of death. PART TAXPAYER RESPONSE FAILt~R ESPO .~IIE ~~' N IC L SME T ~~ 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 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. JJ~~ The above informs ion is incorrect and/or debts and deductions were paid. ~''-'l Complete PART ~2 and/or PART ~ below. PART If indicating a different tax rate, please state ~ \~>'~~FFI,C~~i~°t USE C)NL`Y~~ A~ relationship to decedent: ~C~(1~ ~ ~~~ ~~ ~° 2^ '-'-' ~\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 s 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 `~ 6 7. Tax Rate 7 X 7 , 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct anQd / complete to the best of my knowledge and belief. HOME C~~~ ) 7 ~ ~' ~ C ~Jo .. ~yj• /~yjyj~_ woRK C ) 2-(~ZcC2 TAXPAYER SIGNATUR TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computations s BUREAU OF INDIVIDUAL TAXES PD BDX 2BB6B1 ~r;cl_,~ren~a~~vania HARRISBURG PA 17128- ~~~ pErpAR, •;~UE yy.. , Vf II{_L7~~ ' ~~R~V=1543i•J~~FBw(OS -11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 - ~ 'a - ~ ~ a. AND ACN 12110802 TAXPAYER RESPONSE DATE 02-15-2012 ~~~ CpURt ~~~c~~~ ~~ 'p ALMA M REYNOL ~ A 1015 DREXEL HILLS BLVD NEW CUMBERLAND PA 17070-1737 EST. OF CLARK B REYNOLDS SSN 179-18-3701 DATE OF DEATH 09-21-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE 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 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. 2331025525 Date 04-02-1981 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 $ 9,885.92 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $` 4,942.96 months of the decedent's date of death, Tax Rate ~( , lrj deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 741.44 nine months after the date of death. PART TAXPAYER RESPONSE ~~~ ~ ~OFFI~ L SAX ,~SSES3~IENT A I I,FUI~,~ ~ O L L~°~t E S 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 an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C 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 ~ below. O\ PART If indicating a different tax r e, ple state ,,, OFF,.IC1„AL USE~OIakLY'" ~ AAF relationship to decedent: ~~~~~ ~~ `PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD m~, LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 '~ 6 \ 7. Tax Rate 7 X 7 u 8. Tax Due 8 8 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 5 Under penalties of perjury, I declare that the facts I reported above are^7true~7corr/e/ct/aCn~d/ comp~~lyye~~te to the best of my knowledge and belief . HOME C ~~ ( ) [ ~ `~ -( [ i~ E~ (,CXiYH.,~ ~ ~ W0 R K ( ) Z'~S'--ZUI1„ TAXPAYER SIGNAT R TELEPHONE NUMBER DATE