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Home My WebLink About03-20-12 (3)BUREAU OF INDIVIDUAL TAXES PO BOX 280601 ~~,I~h~Y~~J HARRISBURG PA 17128-0601 {~-'+~Qh~~~IgTMCau:r~oP~ R4M-#56!"EX AM PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 -IZ ~~3Z ~~ AND ACN 12116106 TAXPAYER RESPONSE DATE 03-07-2012 ~oui~ ~~~R 2~ ~~ i~: t~~ CLERK C~ ORPHAN'S C~JURT EDWIN PARRY 39 MICHAEL CT SHIPPENSBURG PA 17257-8129 EST. OF PRISCILLA PARRY SSN 111-22-5605 DATE OF DEATH 11-15-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. BAN K OF AMERICA NA provided the department with the information below, which was used in calculat'in9 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. 002225099165 Account Balance Percent Taxable Date 02-11-1991 Established $ 1,548.31 X 8.333 To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three Amount Subject to Tax 129.02 months of the decedent's date of death, Taz Rate ~( lj deduct a 5 percent discount on the tax due. Any inheritance tax due wall become delinquent Potential Tax Due $ 19.35 nine months after the date of death. PART TAXPAYER RESPONSE ~ FA TU~~SPO ~ IN AN X SM~h#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. 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 Complete informs ion is incorrect and/or debts and deductions were paid. PART ~2 and/or PART ~ below. PART If indicating a different tax t plea a state relationship to decedent: TAX RETURN - CALCULATION 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 OF TAX ON JOINT/TRUST ACCOUNTS 1 l9~S" 2 $ i ~'~• 3 s X ~..3 3 5 6 $ l L ~~GZ 7 X 8 $ I A L U S E [~ ARTMENT OF REVENUE PAD 1 z 3 \ 4 5 6 7 g PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I complet e to the best of my knowled e and beli f reported above are true, correct and , g e . HOME C ~~~ ) ~ G ~! / ~ ~ .~U~17M ~ ,/~Gu1M~~ ~ WORK ( ) ~-;~--/7i ~XPAYER SIGN RE TELEPHONE NUMBER DATE ,~Q-~ Y~~ TOTAL (Enter on Line 5 of Tax Computation) ;: