HomeMy WebLinkAbout02-21-12_ -,~-
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21' I `1- ~+~ ~ ~- ~
,. AND
(' ~~~,~''~~ `~~~~~ER RESPONSE AcN 11107851
BUREAU OF INDIVIDUAL TAXES
Po eox zao6ol ~~~ ~ C? DATE 02-10-2011
HARRISBURG PA 17128-0601 ~+_ ~«~ ~.'J
w ~ i{.. -
REV-1541 E% AFP (OB-OB) TYPE OF ACCOUNT
~1. e L ~ ~.~ ~' 4 t~i ~ ~ ~ `/ ~ SAVINGS
EST. OF MARYANN 0 MYERS ® CHECKING
SSN 164-22-8650 TRUST
CLER~~e DATE OF DEATH of-30-2011 ~ CERTIF.
(~~~}-{~~~~ r.'~~t}~T{~pp COUNTY CUMBERLAND
`-LiI it '~;j-'~ '~'~ , rt4 REMIT PAYMENT AND FORMS T0:
Cta~~F'-' ., . ,
REGISTER OF WILLS
DIANE L CONNELLY 1 COURTHOUSE SQUARE
29 FAIRFIELD ST PA 17013 CARLISLE PA 17013
CARLISLE
MEMBERS 1ST F CU Drovided the Department with the information below, which has been used in calculating the
potential tau due. Records indicate that at the death of the above-named decedent, you were a ioint owner/beneficiary of this accou
mation is incorrect, Please obtain written correction from the financial institution, attach a copy to this form
- nce with the Inheritance Tax laws of the Commonwealth of
If you feel the infor
and return it to the above address. This account is taxable in actor a
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION
Date 07-07-2009 To ensure proper credit to the account, two
Account No. 361391 - 11 copies of this notice must accompany
Established payment to the Register of Wills. Make check
1 ~ 115.0(+ payable to "Register of Wills, Agent".
Account Balance $ 50.000
Percent Taxable X NOTE: If tax payments are made within three
5 5 7 .5 2 months of the decedent's date of death,
Amount Subject to Tax $ , 045 deduct a 5 percent discount on the tax due.
X Any Inheritance Tax due will become delinquent
TaX Rate 25 09 nine months after the date of death.
Potential Tax Due ~`
TAXPAYER RESPONSE
PART
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMEN
A, ^ The above information and tax due is correct.
Remit Davment to the Register of Wills with twoandpreturn this notice to theaRegister of
a discount or avoid interest, or check box "A"
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~ The above asset has been or will be reported and tax Paid with the Pennsylvania Inheritance Tax re urn
ONE
C 0 N L Y to be filed by the estate representative.
C, ~ The above information is incorre3t belowr debts and deductions were paid.
Complete PART 2~ and/or PART
r rT wf 11CF nlJl Y i~l AAF
If indicating a different tax rate, Please state
PART relationship to decedent:
MPUTATION OF TAX ~OINTC~ UST ACCOUNTS
ON
TAX RE TURN - CO r
LINE 1. Date Estauiisi~ed
1
/ ! . O '-f
2. 2
Account Balance
X !'`D 'Y~
3.
3
Percent Taxable
4. Amount Subject to Tax 4 /D ~O• ~"
5. Debts and Deductions 5 $ _6 ,
6, 6
Amount Taxable
X
7. 7
Tax Rate
$ ,,,
_ O
8
vF( a.. ~....._ -__ '--"
PA DEPARTMENT OF REVENUE
PAD _..___
1
3
5
6
7
8
o. ~ e,. ,,.._
PART
DATE PAID
DEBTS AND DEDUCTIONS [:LA11'1~L
Under penalties of Per7url/~ I declare that the facts I have HOME edC ~~ / ) ~~r ~ ~~/ rrect~ ?an~d~
comgJLete to the best of my knowledge and belief . wnRK ( ~/ ~7 ~ ~~'~~ ~ X ~ r J ~
~s
AMOUNT PAID
__ DESCRIPTION
Comfort Suites
10 S. Hanover Street
Carlisle, PA 17013
(717) 960-1000
GM.PA266 C~choicehotels.com
BY CHOICE MOTELS
Comment
Post Date Description
40 Deli Counter
02!04/11 BANQUET FOOD
02104/11 GRATUITY
02/04/11 MEETING ROOM
02/04/11 OCCUPANCY TAX
02/04/11 STATE TAX
1 DISCOVER
Account: 10101344
Name: MEMORIAL LUNCHEON
Date: 02/04/11
Opened: 02/04/11
Opened by: Sjohns.pa266
Status: A
Amount
598.00
113.62
50.00
3.00
42.70
(807.32)
02/04/1
XXXXXXXXXXXX2640
Balance Due: (0.00}
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