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Home My WebLink About05-07-12~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INpIVIDUAL Taxes INFORMATION NOTICE FILE N0. 21 ! a $3'/ Pp BOX 280661 t~i~.,a~k~`E DF AND AcN 12128706 HARRISBURG PA l7lze-BABt tieL[rLe~.y'pT~N,gx:ofNfvexxe.~,'i ~ C TAXPAYER RESPONSE DATE 04-30-2012 F,[l~at'.e~ Kr'105-11)' 1' J u~2ra~Y-7 PN l~ 53 CLERK 0~ ORPHAN'S COURT / CUn~~Fr<, ,~rdrl cc? PA OTTIS R WILLIAMS 122 CAMBRIDGE DR MECHANICSBURG PA 17055-3560 EST. OF DONNA B WILLIAMS SSN 178-'20-5729 DATE OF DEATH (13-12-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FURMS T0: REGISTER OF WILLS 1 COURTHOUSE SQIJARE CARLISLE PA 1-1013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. PNC BANK NA provitled the department with the information below, which uas usetl in calculating the inheritance tax tlue. Records indicate that at the tlea th of the abave-name0 decedent. you were a Joint owner/beneficiary of thi :; account. If you are the sDOUSe of the decease4 and any amount other than zero is reflected below on the Potential Taz Due line, note no taz may be due, but you must notify the de artment 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 ootain written correctf on From the financial institution. attach a coDY to this form and return it to the above adtlress. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5130051685 Date 01-29-1990 To ensure proper credit to the account, two Established copies of Yhis notice oust acconpanv Account Balance 6,770.00 pavnent to the Re6i ster of Wills. Make check aaY able fo "Register of Wills, Alient". Percent Taxable X 16.667 NpTEI If tax pavnents are wade within th rea Amount Subject Te Tax S` 1,128.36 months of the decedent's date of death, Tax Rate X , 0 Q deduct a 5 percent discount on the tax due. Anv inheritance tax due will be cone delinnuenk Potential TaX DUe ~` .OD nine months of ter the date of death. A. he above inform aiion and tax duo is correct. ~ Remit payment to the Reai ster of Wills with two copies of th i:c notice to obtain CHECK a discount or avoid inte resk, or return Yhis notice to the Renister of wills antl an official assessment will ba issued by the PA Deoa rtneni of Revenue. ONE [ BLOCK B. ~ The above asset has been or will be ratio rted and tax paid with the Pennsylvania inheritance tax return ONL Y filed by the estate representative. 0. ~ The above informs son is incorrect and/or tlebts and detlucti tins were paid. C onplete PART ~2 and/or PART 3~ below. PART If intlicating a different tax ate, Please state relationship to decedent: `] I101,{~4 TAX RETURN - CALCULATION LINE 1. Date Establishe0 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. iaz Due PART OF TAX ON JOINT/TRUST ACCOUNTS Under penalties of pe riury, I declare that the Packs I ra portatl above are true, correct and complete to the-best of my knowledge and belief. unur . "777 . ~nQ'7-.Jf WORK ( ) DATE PAID PAYEE DESCRIPTION ANOUNT PAID ~ PENNSYLVANIA INHERITANCE TAX euREAU of 1NDrvlouAL TAxES tC~ r_,-~ INFORMATION NOTICE FILE N0. 21 PD BOx 28D60] p@Il!'laftll~i8 1 `I~iE ~F AND pCN 12128704 HARRISBURG PA 1T32H-D601 oePxaYne ~pty¢hFe i ',j~',I C TAXPAYE R RE S P ONS E ee - s a~Trrt~i6s- , .. _~.~~ DATE 04-30-2012 fit;<1.~3~Y-7 P~9 I~SS CLERK OF ORPHAN'S COUR? CUMBFRi aN(1 f:n PA. OTTIS R WILLIAMS 122 CAMBRIDGE DR MECHANICSBURG PA 17055-3560 EST. OF DONNA 8 WILLIAMS SSN 178-20-5729 DATE OF DEATH iD3-12-2012 COUNTY COMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SpUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. PNC BANK NA provitled the department with the information below. which was usetl in calculating the inheritance tax due. Recortls indicate that at the death of the above-named tlecedent, you were a joint owner/beneficiary of this account. If you are the 5pb05e of the deceased and any amount other than zero is reflected below on the Potential lax Due line, note no tax may be due, But you must notify the deoa rtment 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, Al ea se obtain written correction from the financial institution, attach a copy to this form and return it to the above adtlress. Please call Ill-787-8327 with puesti ons. CONPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 210D1016280 Date D1-28-1988 To ensure proper cretlit to the account, two EStab135hed copies of This nokice must acconpany p avnenk to the Resister of Wills. Nake check Acceunt Balance $ 4,656.00 aav able to ''Resister of Wills, ABenk". Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due CHECK ONE BLOCK ONLY A. X 16.667 $ 776.02 X .00 S .00 NOTE: If tax pavnents are natle wikhin th rea months of the tlecedenT's data of deathr tleduct a 5 percent discount on the tax due. Any inheritance tax due will becpne tlelinouent nine nont.hs after the date of death. above info rnatipn and tax tlua is correct. Resit pays ant to The Resister of Wills with two copies of this nokice to obtain a discount or avoid in ke rest, or return this notice 4o the Resister of Wills and an official assessnenk will be issued by the PA Deparinent of Ra venue, B. ~ The above asset has been or will be repo rtetl and tax paid with Yha Pennsylvania inheritance taX reku rn filed by the estate representative. C. ~ The above info rna ion is incorrect and/or debts and de tlueti ons were poi tl. Conplete PART ~ antl/or PART ~ below. PART If indicating a different tax rake, pl ase state "Y3r( ~" ,""' *7 l~'' "i i+ '~ ,wll : , ~ ~ relationship to decedent: ~ 1 ~~ P' : s' i! ~~~ ~`t~ ,~ ~ TAX RE TURN - CALCULATION OF _'~~ ~~ '` ~5 "?~ TAX ON JDINT/TRUST ACCOUNTS i ~ ~ I ~ DY~! LINE 1. Date Established 1 `a '-~ ` `v 2, Account Balance 2 +S 3, Percent Taxable 3 X 4, Amcunt Sub}act to Tax 4 s 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. iaz Due 8 vS PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK ( ) Untler penalties of pardury, I declare that the facts I reported above are true, correct antl~/ complete to the befit of my knowledse antl belief. ufaMC ! ~1 7 • /n4'7-~.\ Y~ - ~~ r I. ': ~, `~.. V Q ~' h~ 41 i+t ~ ~ , 1 ~ / ~r l v Is'~ k~ l+"1 ~^ ~ ~ ~ ~~^~• `~ ~ 4F n~ ~ ~; per ^' h~ t~ii ~~' '"~ / V~ ¢{~y`J_ C?.T r' P P ..~ V9A~IN ~'