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Home My WebLink About03-27-12BUREAU OF INDIYIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 DEPART7(y`';~~.',µj~OF RE REV-1543-EVL' fIEP': PENNSYLVANIA INHERITANCE TAX 1-~ INFORMATION NOTICE FILE N0. 21 1d~-~-~~°~ AND ACN 12119703 ~.., 1 ~'~.E O~ TAXPAYER RESPONSE DATE 03-21-2012 ~'j~lZ~i~R 27 ~i''~ I~. 26 c~~R~ of ORPHAN'S ;GUR r JAMES DAV'IS 96 CHERRY LN CARLISLE PA 17015-7834 EST. OF PATRICIA A DAVIS SSN DATE OF DEATH 06-17-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAYINGS ® CHECKING TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the department with the information below, which was used in calculating the inheritance tax due. deceaseddandtanyaamounteother thanezeroeisareflectedtbelowwonetheoPotentlalbTax~Dueylineh~noteono tax maybe duehbut you must he 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 cell 717-787-8327 with questions. _ COMPLETE PART 1 BLOW * SEE REVERSE SIDE FOR FILING AND PAYMENT-INSTRUCTIONS Account No. 6225719052 Date 01-25-2010 To ensure proper credit to the account, two Established copies of this notice ^ust accompany payment to the Register of Wills. Make check Account Balance ~` 11 ~ 171 • 98 payable to "Register of Wills, Agent". Percent Taxable X 50 • 000 NOTE: If tax payments are wade within three Amount Subject to TaX $ 5,585.99 months of the decedent's date of death, X • 1 5 deduct a 5 percent discount on the tax due. Tax Rate Anv inheritance tax due will become delinquent Potential Tax Due $ 837 • 90 nine months after the date of death. PART TAXPAYER RESPONSE F=AIL £ 0 ~ WILL SitLt I AN s0~#CI TAX- EN HECK A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with a discount or avoid interest, or return this an official assessment will be issued by the two copies of this notice to obtain notice to the Register of Wills and PA Department of Revenue. C ONE B L 0 C K 0 N L Y B. ~ The above asset has been or will be reported and filed by the estate representative. tax paid with the Pennsylvania inheritance tax return ~ C. The above informs ion is incorrect and/or debts Cowplete PART ~2 and/or PART ~ below. and deductions were paid. PART If indicating a different tax rate, please state a relationship to decedent: --~v^ ~~ 5 TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject tp Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS PAD I cs z $ 3 X 4 $ 5 6 '~ 7 X 8 i DFFjCIA1.-, USE U~1LT ~r PA DEPARTl1~NT OF REVENUE 1 2 3 _ .. ,_._ _ .. ._ , "- _ -~ _, 5 DEBTS AND DEDUCTIONS CLAIMED PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 9 Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief. HOME C ~ WORK C ~ ~_ TELEPHONE NUMBER DATE TAXPAYER SIGNATURE ~ PENNSYLVANIA INHERITANCE TAX +~~ ~ ~~ INFORMATION NOTICE FILE N0. 21 ( -~ BUREAU OF INDIVIDUAL TAXES ~~ 5 ~ Qt_ AND ACN 12119704 Po Box zao6ol ~, ~!t {- DATE 03-21-2012 HARRISBURG PA 17128-0601 ~dt.dFREvENuB!( !~ TAXP AY E R RE S P O N S E REV-1543 E%AFP <05-11~,`-~"~'f TYPE OF ACCOUNT '['t~~-~R27 AlI' Zb CLERK OF ORPH.AN'S ;;OURr Ct;th~a~~?i .~r~d c;o PA JAMES DAVIS 96 CHERRY LN CARLISLE PA 17015-7834 EST. DATE OF DEATH 06-17-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 SAVINGS ® CHECKING TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA provided the department with the information below, which was used in calculating the inheritance tax due. Recorasedndandtanyaamou teother thanezeroeisareflectedtbelowwonethe~Potentialb Taxi Dueylineh~note~no tax mayo be due h but you must he notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART dece If you believe the information is incorrect, Dlease obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-6327 with Questions. ____. ___ ...er , nrr nu a SEE REVERSE SIDE FOR FILING AND .PAYMENT. INSTRUCTIONS. Account No. 6218996569 Date Established 06-15-2007 To ensure Drover credit to the account, two copies of this notice oust accompany payment to the Register of Wills. Make check A nt" $ 1 , 690.72 payable to "Register of Wills, 9e Account Balance ~( 5 0 • 0 0 0 NOTE: If tax payments are made within three Percent Taxable 845.36 months of the decedent's date of death, Amount Subject to Tax $ 1 5 deduct a 5 percent discount on the tax due. will become delinquent d Tax Rate X • 126 • $0 ue Anv inheritance tax nine months after the date of death. Potential Tax Due ~ TAXPAYER RESPONSE PART Ct#R£ Tt? RE~ tiD {~i £~IiLT IH'AH iDFFICI L °7AX E CHECK ONE [ BLOCK ONLY A, ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain 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. g, ~ The above asset has been or will be reported and tax vaid with the Pennsylvania inheritance tax return filed by the estate representative. The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax S they, f PCB se state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAI LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate ~ X m Tex rlue $ Y PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) Under penalties oflperjury. I declare that the facts I reporHOME ov( are t~ e, correct and complete to the best of my knowledge and belief. WORK c ~ TELEPHONE NUMBER DATE TAXPAYER SIGNATU E _ - DEBTS AND DEDUCTIONS CLAIMED ~_ ~--_ I, ~~` ~~~ =~ N ~- N m ~ o v~ w nr-5. ~ ~ N _~ 4 C]l V W W J> 1^" k,,.~ pJ• ~~ ~~ tit {A3 ~~ h) C7 --' ~ won ~" C v~ ~ ~ -~ ~' ~ [r] ~x~ 0 ,~~o a~,~ ~~ Wa z r~... /^-~ r C`•/ ~._ ~~~ .~ ...+- .rs .~ ~ ~~ " J- T : _ -~C'7C~ ry "'1-' f ~ ~T .1 D .. yJ ~ /1 • `~~ ,` vsni~t ~~~, ~~~~