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Home My WebLink About04-05-12 (4)BUREAU OF INDIYIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~. pennsyl~y DEPARTMENT OF A REV-1543 EX AFP PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0788 ~, .r ; ~~ ~ FeeyyFFRRAND cppnN ACN 12100011 "* * ~~E~IISED ~~TIC~"S~ * * DATE 03-02-2012 r . 1.'J ~i~l~~?R-5 ~~ 8~ c CLERK OF ORPHr1(~!'~ ,;OtJF,T Cl Ii~1QF~; ~,,,1 1,^;~, PA EST. OF MARGARET E FISHEL SSN 168-24-2983 DATE OF DEATH 07-05-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: PAMELA K FRAZIER REGISTER OF WILLS 4695 SEARS RUN DR 1 COURTHOUSE SQUARE MECHANICSBURG PA 17050-2560 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. A MERICHOICE FCU 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 art the 5pOU5e 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 I BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS iaccvunc no. J45/1-6U Date 11-22-2002 To ensure proper credit'to the account, two Establ ished copies of this notice must accompany Account Balance $ 5,580.66 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 2, 790.33 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 125.56 Any inheritance tax due will become del inquent nine months after the date of death. PART TAXPAYER RESPON SE 1^ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT 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 not ice to the Register of Wills and C 0 N E an official assessment will be issued by the PA Department of Revenue. ~ BLOC K 0 N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return file d by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid Complete PART 2~ and/or PART ~ below. . PART lr indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 _ 5 6 $ 7 X 8 $ OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION eMniiur pern ~~ ~,~ amine ~ or iax computation) g Under penalties of perjury, I declare that the facts I reported above rare ytrue, correct and co„typ~yete t~o®_t he'jb1est~ofTm~y knowl@.dge and belief. HOME C !~/ ) ~ --~Q _ IUGL-i~ % ~'-I~CGL.~/-) - "/.,~1G1%~/!/ WORK C / `7 ) 'T~~ -"~~.~ ~ /dpi TAXPAYER SIGNATURE TELEPHONE NUMBER DAT BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 pennsylvQ DEPARTMENT OF RE' REV-1543 EX AFP CLE~~ ~c ORPN,~PJ'L '~'` <11rt'' PAMELA K FRAZIER 4695 SEARS RUN DR MECHANICSBURG PA 17050-2560 TAX FILE N0. 21 11-0788 ACN 12100011 DATE 01-03-2012 ~~ 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. AMERICHOI CE FCU 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 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 call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 34571 Date 11-22-2002 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 16,651.34 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject to Tax ~{` 1,387.56 NOTE: If tax payments are made within three TeX Rate months of the decedent's date of death, X . 0 4 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 62.44 Any inheritance tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE a FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT 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 ~ 0 N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inherit ante t f ed by the estate representative. ax return C. The above informs ion is incorrect and/or debts Complete PART ~ and/ PART and deductions were paid. or ~ below. h'AKI it inaicaiing a tlifferent tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2-- $ Ao l~l~. 3 X ~y/~p, 5 - ~-- L7 ~ 6 $ ~ 7 7 X . n r~~~ 8 $ PART PENNSYLVANIA INHERITANCE INFORMATION NOTICE ~~ _ AND 1 ~ L~>~YER RESPONSE OFFICIAL USE ONLY ~ AAF PA DEPARTMENT DF REVENUE PAD 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION ~uni~.,r .,. r,. 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 ~~ ~ ~ / ~~,~r:~c. ~~ °i~.~-~~~-i, woRK c x1/ 1 ~ r1~d ° is~-9 3 TAXPAYER SIGNATURE TELEPHONE NUMBER D T