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HomeMy WebLinkAbout05-09-12~~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES r~[,~,vn~m•~-~-.t-.,,_ INFORMATION NOTICE FILE NO~ja,-~a-oy-~ PO BOX 280601 ~((y}~ -~(L7r~. HARRISBURG PA 17128-0601 ~"_~'~~?~~~„~ O' AND f'~ElPAgT{~4N~DF f#EVENU~ ! ~ TAXPAYER RESPONSE ACN 12128605 RED-,54, Ex AFP X05-;,, DATE 04 - 30 - 2012 :~~1 '~Fi~' -9 f'H I~ ~, Or.~r'r rti'e ~; ~~ , ., i CUfv1~~R~~,tJ~ CCU , PA TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. HELEN P GARVIN 121 RATHTON RD YORK PA 17403-3743 EST. OF ERNEST E GARVIN SSN DATE OF DEATH 03-04-2012 COUNTY YORK REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 45 NORTH GEORGE STREET YORK PA 17401-1240 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, please obtain written correction from the financial institution, attach a cony 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. 6100681351 Date 06-06-1966 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 7,351.73 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax ~` 3,675.87 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate ~( ~ 15 deduct a 5 percent discount on the tax due. Potential Tax Due $ 551 .38 Any inheritance tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 0 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 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. BLOC K B. ~ The above asset has been or will be reported and tax 0 N L Y paid with the Pennsylvania inheritance tax return fi14d by the estate representative. C. ~he above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3u below. PART If indicating a different tax t~ please Mate relationship to decedent: o ~,j OFFICIAL USE ONLY [~ AAF TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD PA DEPARTMENT OF REVENUE LINE 1. Date Established 1 1 2. Account Balance 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 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts f.,omplete to the best o f my knowledge and b l I reported above are true, correct and _- e ief. ~ j(_ '/ V i ~- t / ~'.~"F~J ~~f ~~"f(" TAXPAYER IGNATURE 1-~~ WORK C~~~ ~ ~L'4~-~99~ '7-ka _ _ _ TELEPHONE NUMBER DATE ~_ ~~; ~~'~~+ d #e. ~~, t"r ~~ ~. ~+r f ,.~ r~ -k wk's , ~ ~_ .-~ N !Q V ~+ N L .. ~.~. w O w a W Q a w W E- W z w U GQ ,~ z<~~, o < ~r o~^~ v.~~ ~!z~ o :~ W ~ "s ~ o 'x W : , ~ z EU W ~.~~.~ :4 H 1, C J a~ 0 0 U ~, ~ M ~ ^' ~ ~ ~ U K;' r C, .. C~ 4-I ~, ~., ' ' ~ ~ v ~ ~ a.~ cd U a:. U