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HomeMy WebLinkAbout03-21-12 ,~ • BUREAU OF INDIVIDUAL TAXES PU BDX 286661 C" ,;,rj•~ HARRISBURG PA 17128 J ~~` ~ ~~ ~ ('~~~'!~lnpnia ~ ' ' '" ` "" " ~ + "bEaA~i ME 1SF EVEN UE r~,~;.,,;, - ' 4~ Li',~ ( ` ,,,~,~ ~ R~"154~'E;;.~af~ (05-11) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 - IZ -C;3yZ ACN 12115221 DATE 03-02-2012 %~~?. I°i~ft 2 I F'~ 3~ I b CLERK OF oR~~v~s co~~~T LISA R DAVEY 5820 SPRING TREE CT ENOLA PA 17025-1183 EST. OF MILDRED M GARLINGER SSN DATE OF DEATH 10-25-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: 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 i 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 farm and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE RE1lERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 241769020 Date 04-20-2009 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 878 09 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to TaX $ 439.05 NOTE: If tax payments are made within three TaX Rate months of the decedent's date of death, X 1 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 65.86 Any inheritance tax due will become delinouent nine months after the date of death. PART TAXPAYER RESPONSE Fq~ T ~ 0a ~ ~Ta ~ OF C~L~ TA~~C~~AS'!RFSCMF-JT 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 C 0 N E ~ an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~ The ab ve asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return O N L Y fil by the estate representative. C. he above informs Son is incorr~ect and/or debts and deductions were paid. Complete PART 2~ and/or PART IJ below. PART If indicating a different to rate ,. please skat relationship to decedent:-"Y/_/~f] 1~,~71-~TA,T,~f/',1-+r/~7/~ s QFFICIA,eL USE (~aiLY aAAF TAX RETURN - CALCULATION OF TAX ON JO,INTU/TRUST ACCOUNTS PA DEPARTMENT OF REVENUE ,~ ((pp ~ PAD 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 - Q 5 6. Amount Taxable 6 $ ~ 7. Tax Rate ~ X • U ~-fS- 7 8. Tax Due B $ ~ 8 PART DEBTS AND DEDUCTIONS CLAIMED ^S DATE PAID J PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) g Unde enalties of perjury, I declare that the facts I reported above are true, correct and com le to t best of my knowledge and belief. ~~~ ~ ~l HOME ('7/ 7 ) ~ ~ ~ i WORK ( ~ ~ T P R SIGNATURE TELEPHONE NUMBER DATE aan ` ~ ismivsn ~. 4u.. ~:; ,a ,_; ':::- ~Tr ry,.h `~ ~= '~ ~~ +~,- r; "~., ^"~ ,~i. ~~r- wY l'r w ' ~ %' I~~ ~~ ~~ i ~~~ 3~ ~ ~ i,~ S J U s~ ~jf i=i i'3 i.~ ;~ •i^7 3 ~l vd