HomeMy WebLinkAbout03-29-12PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 11-1250
BUREAU OF INDIVIDUAL, ~~ 1r-;° ~ r~' (''~~
PD BOX 280601 f~~l~t.`' ;i;;~Peri~ 1~dnla AND ACN 12107967
HARRISBURG PA 17128-0~ "' (1EbA~ThI~~EVENUE TAXPAYER R E S P O N S E
t;~',;.,_: ~_ ~ ..~ ..~.~ DATE 02-03-2012
REY-1543+EX RrP (OS-11)
~
.,r,l~~in ~~ ~;,,~' ~ TYPE OF ACCOUNT
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EST. OF
ROBERT A NICHOLS
~ SAVINGS
EP~~ ~.~
Ci SSN ® CHECKING
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~uz
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) : DATE OF DEATH 09-15-2011 ~ TRUST
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CUr COUNTY CUMBERLAND ~ CERTIF.
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,',,( REMIT PAY MENT AND FORMS T0:
SHIRLEY A NICHOLS REGISTER OF WILLS
423 HILLSIDE RD 1 COURTHOUSE SQUARE
NEW CUMBERLAND PA 17070-1863 CARLISLE PA 17013
SDVEREIG 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 Sp0U5e 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. 0771041926 Date 02-07-2001 To ensure proper credit to the account, two
Established copies of this notice roust accowpany
Account Balance 27,547.22 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to TaX $ 13, 773.61 months of the decedent's date of death,
Tax Rate ~( lrj deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 2, 066.04 nine wonths after the date of death.
PART TAXPAYER RESPONSE
ILUi~ O R£SPU LL : SU , TW~ ~1~1 -~ F.IGiAL A 5iiENT
A. ~ The above inforwation and tax due is correct.
Rewit 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 assesswent will be issued by the PA Departwent 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 return
0 N L Y filed by the estate representative.
C. The above informs ion is incorrect and/or debts and deductions were paid.
Cowplete PART 2~ and/or PART ~ below.
PART If indicating a different t x r te, ple•se s ate ~
~ ~ - ` FFIiAL E QLY.~~Q AA
2 relationship to decedent: ~ PJI4DEPARTMENT DF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD --'`
LINE 1. Date Established 1 1 _ --~" ~~
.., ,,. _,
2. Account Balance 2 $ 2
3. Percent Taxable 3 X __ 3
4. Amount Subject to Tax 4 $ ~y
5. Debts and Deductions 5 r~
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X ~ 7
8. Tax Due g $ 8 '~~.~ ~.u ~.ti ~.~
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are rue ,gQI`re ~ n
mplete to the best of m Howled a and belief . HOME C 1~ ) -11 y`
~^ •c~ WORK C )
TAXPAYER SIGNA RE TELEPHONE NUMBER D TE
IUTAL ctnter on Line 5 of Tax Computation) S