HomeMy WebLinkAbout04-13-12 (3)' j PENNSYLVANIA INHERITANCE TAX (~(~/ _~
BUREAU of INDIVIDUAL TAXES ~~ INFORMATION NOTICE FILE N0. 21 "- ~~' r /
PO BOX 280601 pennsylv~~ :7f~__r~
HARRISBURG PA 17128-0601 ~ ~ .. r AND ACN 1 1171652
DE PARTMENT OF REVF.tyIJF _, 1'~.~!~-YER RESPONSE
REV-1543 E% RFP (O~ai]),,: ` ~: ~ ~ t (~ DATE 10 - 31 - 2011
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SHERRY L WINTERS
305 CASCADE RD
MECHANICSBURG PA 17055-5518
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
EST. OF ROBERT G YEAKLEY
SSN
DATE OF DEATH 09-12-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
P NC BANK NA 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. 1021951192 Date 02-15-2007
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 4,468.00 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to TaX $ 744.68 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 ~` 33.51 Any inheritance tax due will become delinquent
nine months after the date of death.
Par TAXPAYER RESPONSE
~ FA~LU#tE ~,T'ORE~ O~1D p1IL~.. RCS L° ~N ~OFFBCI~IL 7AX 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 g, ~ 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 incorrec
t and/or debts and deductions were paid
~
Complete PART 2~ and/or PART 3LJ below. .
PART if indicating a different tax rate, please state
relationship to decedent: OFFICIAL USE ONLY
~ AAF
TAX
RETURN - CALCULATION OF
TAX ON JOINT/TRUST ACC PA DEPARTMENT OF REVENUE
OUNTS 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 - 5
6. Amount Taxable 6 $
6
7. Tax Rate 7 X
7
8. Tax Due g $ 8
TART DEBTS AND DEDUCTIONS CLAIMED
U r penalties of perjury, I declare that the facts I reported above are true, correct and
om lete to th/e b~j~t~of my knowledge and belief. HOME C7~~ } ~~'~ - ~S 13
TAXPAYER SIGNATURE TELEPHONE NUMBER A E
DATE PAID PAYEE DESCRrarrnu ....,,...r ... _..