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Home My WebLink About03-29-12 (3)~ PENNSYLVANIA INHERITANCE TAX ~~ ~ ~~- , ~ , INFORMATION NOTICE BUREAU of 1NDIVID ~ ~ F I L E N0. 21 11 -1250 Po eox zao6ol ., ~Q'n~~ vania AND ACN 12107969 HARRISBURG PA 1r1zeR~4etl,,,, ~ ~EPAAxr~EUr,sFREYEN~E TAXPAYER RESPONSE DATE 02-03-2012 REY-1543 E% RFP 05-11) r4i3i~~o'fifSC_.J f~,.i~, ~.iv Cl_EFI~ C ~ r 'R°H.~fv'~ ~'~,~,if~ 4'l" .5 ^ '1 EST. OF ROBERT A NICHOLS SSN DATE OF DEATH 09-15-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: SHIRLEY A NICHOLS REGISTER OF WILLS 423 HILLSIDE RD 1 COURTHOUSE SQUARE NEW CUMBERLAND PA 17070-1863 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 y0U are the 5p0U5e 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. COMPiETE PART 1 BELOW * SEE REVERSE SIDE FDR FILING AND PAYMENT INSTRUCTIONS = Account No. 2334020951 Account Balance Percent Taxable Date 03-20-1987 Established $ 1,555.73 X 50.000 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". Amount Subject to Tax $ 777.87 NOTE: If tax payments are made within three 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 $ 116.68 nine months after the date of death. P~T TAXPAYER RESPONSE ~ AILU~E E POND rt'';N>. F L ASS NT 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 0 N E an official assessment will be issued by the PA Department of Revenue. B L 0 C K ~ g, ~ 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. Complete PART ~ and/or PART 3~ below. r PART it intlicatang a tlifferent tax rat4,~lease state ~ OFFIC I~AL USE 0~'iLY~ 0 relationship to decedent: WW , AA PA DEPARTtiENT 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 $ ~ 4 5. Debts and Deductions 5 S Q 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 ~ ~u PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AM~uNT Parn .,~ i~n~er on a ne ~ or iax Computation) S Under penalties of pe ury, I declare that the facts I reported above a true correct d omelet to the best of knowl ge a belief. HOME C ~ ~ \ WORK C J TAXPAYER SIGNA E TELEPHONE NUMBER D TE