HomeMy WebLinkAbout02-21-12~ PENNSYLVANIA INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxES r-I~r~r~ nrr-( ,, INFORMATION NOTICE ~ - ~„
Po Box 280601 ~~11 EVd1118' ^ ~~~ AND FILE N0. 21~0„c U~c.~L
HARRISBURG PA 17128-0601 ~ "'r~~~ - ACN 12110853
DE(44tFYMENT iQF RE~EN~E ~.' ; ~ TAXPAYER RESPONSE
R}EV-1543E%RFP(OS-11) •.'J DATE 02-15-2012
J
GLER~ Or
ORFH.~,,~~~ ~GtJ~~
EST. OF RAMSEY L WARD
SSN 184-12-3200
DATE OF DEATH 02-06-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
GRACE E WARD REGISTER OF WILLS
212 CUMBERLAND DR 1 COURTHOUSE SQUARE
CAMP HILL PA 17011-6672 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU 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 bel;eve 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. 70830-11 Date 09-08-1997
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 1 , 332.99 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax $ 2 2 2 . 1 7 NOTE: If tax payments are made within three
months of the decedent's date of death,
TaX Rate ~( , 00 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 00 Any inheritance tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
1^
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
0 N E an official assessment will be issued by the PA Department of Revenue.
BLOC K ~
0 N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax
t
filed by the estate representative. re
urn
C. ~he above informs ion is incorrect and/or debts
Complete
PART ~ and/
PART and deductions were paid.
.
or
~ below.
PART If indicating a different tax rate, please s a e
relationship to decedent'• ~ I"1 ~I p~
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 $
~ X
4
5 -
6 $
7 X
a $
PAD
1
2
4
5
6
7
8
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMn((~(r owr.,
Under penalties of perjury, I declare that the facts I reported above are true, correct and
comp ete to the best of my knowledge and belief. HOME C ~~~ ~ .,~~ (/ J~~-
~t ~ WORK ( ~
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
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