HomeMy WebLinkAbout03-21-12BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 ~'~~~/f~
HARRISBURG PA 17128-0601 ,'._..~
ILD~ REVENU~q
EX. AFP ~CB'S-11fi
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
~~ AND FILE N0. 21-~!,,Z-~~Q
~ TAXPAYER RESPONSE ACN 12115144
iv DATE 03-02-2012
.:~' Lt ! i L~ 1 3'. 4~ V 1
CLARK C~.
OF?PH~1`~ COURT
GEORGE H SEIDEL
110 VALLEYVIEW RD
NEW CUMBERLAND PA 17070-1731
EST. OF LOIS J SEIDEL
SSN 184-26-4634
DATE OF DEATH 10-22-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
SOVER EIG N 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. 0771027443 Date 01-25-1992 """'~~-- ----
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 296,719.78 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject t0 Tax $` 148, 359. $9 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate
X 1 5 deduct a 5 percent discount on the tax due.
Potential Tax Due $` 22,253.98 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 Will
C 0 N E ~
an official assessment will be
issued by the
PA Department s and
of Revenue.
S L 0 C K
0 N L Y g, ~ The above asset has been or will b e reported and tax paid with the Penns
l
i
filed by the estate representative
. y
van
a inheritance tax return
C
PART
TAX
If indicating a different tax rat please state
relationship to decedent:
RETURN - CALCULATION OF TAX 0 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
PART
0
1
2
3 X
4 +~'
5 -
6
7 X
8 $
PAD
1
2
3
4
5
6
7
8
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) g
Under penalties of perjury, I de Tare th the facts I reported above are true, corre t and
complet to the best of my kno dge d el'ef. HOME C ~ ) > 7 ~ ! ~ ~ 1
WORK C )
T PAYER SIGNA RE TELEPHONE NUMBER
A
The above informs ion is incorrect and/or debts and deductions were paid.
~plete PART 2~ and/or PART 3~ below.
-__
George H. Seidel
110 Yalleyview Rd
,Kew Cumbedend, PA 17070
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