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-~ PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 11-0788
BUREAU OF INDIVIDUAL TAXES
Po Box 2BObo1 penn~i~riia[ z;~ ,~ AND ACN 11149956
HARRISBURG PA 17128-Ob01 DEPARTMENT flfi ENU ~~~~~~ ~~1S~~S
~'~~- `~ ~~- ~ ~~ ^ ~ * * DATE 08-30-2011
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VICTO FRAZIER
5 SEARS RUN DRIVE
MECHANICSBURG PA 17050
EST. OF MARGARET E FISHEL
SSN 168-24-2983
DATE OF DEATH 07-05-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST F CU Drovided 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 ce" 1ll-787-A327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 245053-57 Date 03-02-2010 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance ~` 1 , 947.03 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to TaX $ 973.52 months of the decedent's date of death,
Tax Rate ~( 0C}5 deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 43 • 81 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due i5 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
C H E C K an official assessment will be Sssued by the PA Department of Revenue.
C ONE
BLOC 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. ~he above information is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART ~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ ~~ (17 2
3. Percent Taxable 3 X ~'1 Lt• ~~ 3
4. Amount Subject to Tax 4 $ i^~ ~~'3. -~~"~ 4
'' 5
5. Debts and Deductions 5 "~
6. Amount Taxable 6 '~ 6
7. Tax Rate 7 X = ~ ~J 7
8. Taz Due 8 'fi ~ ~' ~/ B
PART DEBTS AND; DEDUCTIONS CLAIMED
a
naTF pain PAYEE DESCRIPTION AMOUNT PAID
IUIHL itn~er un zinc -~--
Under penalties of perjury, I declare that the facts I
comp]~ete to the best of~y knowledge and elief.
~XPAYER SIGNATURE
reported above are~/true, correct and
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WORK (~j~ ) ~f(Q~~'fl~tY~
TELEPHONE NUMBER AT
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17129-0601
~ PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
AND
~ic~»~~,L ~~~~/mss TAXPAYER RESPONSE
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VICTOR FRAZIER
460 SEARS RUN DRIVE
MECHANICSBURG PA 17050
FILE N0. 21
ACN 11149956
DATE 07-27-2011
EST. OF MARGARET E FISHEL
SSN 168-24-2983
DATE OF DEATH 07-05-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
'~ CERTIF.
MEMBERS 1ST FCU provided the department with the information below, ~dhich was used in calculating the inheritanc=_ tax due.
Records ind~.~cate 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 helieve the information :s incorrect, please obtain written correction from the financial institution, attach a copy to this form aoC return
i*- to the above address. Please call 717.-787-8327 with puestions. _ _
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 245053-57 Date 06-02-2011
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ ~l,~j,-~~?.~~ ~~ .. ~,.~,g.~~, payment to the Register of Wills. Make check
`~ '~ payable to "Register of Wills, Agent".
Percent Taxable X '~ lA-0=-0~U
'~f~ ~ --
Amount Subject t0 TaX ry „~. ) NOTE: If tax payments are made within three
$ ~X "f "/~+,,y-s~5 1~=y=9.47---"0-3 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Potential TaX Due $ ~ ~ / ~~ Any inheritance tax due will become delinquent
~ =8_7 :°6-2 nine months after the date of death.
PART TAXPAYER RESPONSE
_ _ _ d
FAIL~~URE TO ESPOND WILL_RES.ULT. IN AN, OFFICIA TAX AS5ES5MEFJ'~
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 O C K ~ g, a bove ass a been or w 1 be reported and
O N L Y pa' with t P nsylva inherit tax return
f~ a by a estate epre tativ .
~_
C. The above information is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART 3L-J below.
PART If indicating a different tax rate, please state ~:,~ ~ "
relationship to decedent: ~ n~DFFI,L'IAL .USE .C1~1LY. ~j AAF
PA DEPARTMENT OF,REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRU T ACCOUNTS PAD
~~77
!-INE--1 .- Date -Est-ahiish.ed _ _ i ~ ~ r1t-=- ~ __. . ---- - .. __i rr, _
i~ h 1 -
2. Account Balance 2 $ T_~° }/~~ : 2
3. Percent Taxable 3 X ~~ lj~ 3 -
4. Amount Subject to Tax 4 $ ~~~~xC~ 4 -
5. Debts and Deductions 5 - ?~ °" 5
6. Amount Taxable 5 $ ,,~~~~t.I'~7 ,~LL 6
7. Tax Rate 7 X ss ,~`'T `~ 7 ,
8. Taz Due g $ j/? /~ ~ ~? 8
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION n~snii-,r o~rr,
Under penalties of perjury, I declare that the facts I reported above a
re true, cor
rect and
complete to the best of my knowled~ge/,and belief. 22
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HOME C /~~ ) ~~J "~~~~
TAXPAYER SIGNA TURE ~ TELEPHONE NUMBER D T
._..._ __.. -... ..,, ~.,,~ ~ ~i Tan ~omPULailOn) S
Viktor M. Frazier
4695 Sears Run Dr.
Mechanicsburg, PA 17050
March 8, 2012
Ms. Leigh-Ann Stallings
Lending Insurance Support Specialist
Insurance Department
Members 1St Federal Credit Union
5000 Louise Drive
P. O. Box 40
Mechanicsburg, PA 17055
Re: Margaret E. Fishel, Deceased
Viktor M. Frazier
Joint Account #245053-57
Dear Ms. Stallings:
I am the joint owner on CD #245053-57. Please transfer this CD to my account #203947,
at the same rate and maturity date.
Also, enclosed is a copy of a Revised Notice of an Information Notice and Taxpayer
Response Form from the Pennsylvania Inheritance Tax pertaining to CD#245053-57.
The Account Balance on this form is incorrect. It should be $4,947.03, vs. $1,947.03
listed on the form.
Please do a letter to the Pennsylvania Inheritance Tax Bureau of Individual Taxes to
revise the Account Balance and the calculation of the Amount Subject to Tax and the
Potential Tax Due.
Thank you.
Sincerely,
Viktor M. Frazier
VMF:vmf
Enclosure