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Home My WebLink About04-18-12 (3)~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE No. 21 - ~:7 - 1-}~~ BUREAU OF INDIVIDUAL TAXES - l Po sox zsa6ol rr ~ AND ACN 12125003 HARRISBURG PA l~lze o601'~' ~ ~ ~~~~ veNQ~ TAXPAYER RESPONSE . `ti~_; ..RED-:s4s~x god cu#_9~> DATE 04- 12-2012 '`'L ~~~ ~ 8 F'°r~~ I~ 21 CLER~~; ~'~`~ OR~'HAf~i'S ~:~C`..;1~.~ KAY F KANN 1836 WALNUT BOTTOM RD NEWVILLE PA 17241-9510 EST. OF RICHARD L KANN SSN DATE OF DEATH 03-29-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA 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 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, Dlease obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6100793788 Date 03-29-1980 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 448.91 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 $` 224.46 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 $ 33.67 nine months after the date of death. P~T TAXPAYER RESPONSE ~ 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 an official assessment will be issued by the PA Department of Revenue. C ONE 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 Son is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART a below. PART If indicating a different tax _rate, pled state relationship to decedent: ~ ~d L.L.S fs TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ z. ~ercen[ Taaetr3e -_ - - ~--~ ------__.--- 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ PAD i .. -u3 ~': - :. n ~:- 7 8 PART 0 DATE PAID PAYEE DESCRIPTION ~ ~~~~ k~, ' ter: x~ .. %, ~fY.h .. ~ =. AMOUNT PATT) Under penalties of perjury, I declare that the facts I reported above are true, correct and ~~c/omplete to the best of my knowledge and belief . HOME C ~~ ) - ~ 0 ~' /L ~7 ~ . ~C/Crr~.~ -.J W O R K C ~ y / ~ / ~. TAXP ER SIGivAIURt TELEPHONE NUMBER AT DEBTS AND DEDUCTIONS CLAIMED OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE IuIgL Fencer on Line 5 of Tax Computation) S