HomeMy WebLinkAbout05-09-12 (3) ~j PENNSYLVANIA INHERITANCE TAX
BUREAU OF INDIVIDUAL raxES
Po Box zaocol
r.{Cr~;~.'' ~: ~~
~~~~~nia INFORMATION NOTICE
AND
FILE N0. ~-a~-ia -oy~9
T
~
HARRISBURG PA nlz Otioi~- • ~ P~,
_. ... -DEPART(N,€ T EVENUE
:
;
r`
' TAXPAYER RESPONSE ACN 12128607
,;.-
."
:.
. . Q~v-i54a~ba+.ar~ cos->>> DATE 04 - 30 - 2012
C
CihNrlf>J'V ~ : ~i~h;r
Cl1 V~~~F~'Lw~~ CO., PA
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
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, 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. 6231189205 Date 08-18-2010
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 3$,254.34 Payment to the Register of Wills. Make check
Percent Taxable X payable to "Register of Wills, Agent".
16.667
Amount Subject to Tax $ 6,375.85 NOTE: If tax payments are made within three
Tax Rate months of the decedent's date of death,
X 1 5 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 956.38 Any inheritance tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
0
FAILURE TO RESPOND WILL RESULT TN 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 obt
i
C H E C K
a discount or avoid interest,
or return this
notice to the a
n
Register of Will
d
C
0 N E ~ an official assessment will be issued by the PA Department s an
of Revenue.
B L 0 C K
0 N L Y B. ~ The above asset has been or will b
fal
' e reported and tax
Paid with
the Pennsylv
i
gd
by the estate representative
. an
a inheritance tax return
C• ~ie above informs ion is incorrect
Complete PART ~ and/or PART ~ and/or debts and deductions
below were paid.
.
.,R~ .~ +~iuicacing a different tax t le se tate
relationship to deredent: ~'~d1.1_~
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rate ~ X
8. Tax Due g $
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE.
PAD
i
2
3
4
5
6
7
8
r~' DEBTS AND DEDUCTIONS CLAIMED
3
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computationl g
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complet to the best of my knowledge and belief.
' HOME C ~
AXPAYER SIGNATURE ~ WORK ( { ) -~~ ~ -7-~a
TELEPHONE NUMBER DATE