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HomeMy WebLinkAbout05-09-12 (4)~ PENNSYLVANIA INHERITANCE TAX BUREAU of INDIVIDUAL T INFORMATION NOTICE Po Box zaocol ~~' ~' penrhsy~Y~iia AND FILE N0. ~a~'~a-~~Ci HARRISBURG PA 17129 06~j`" ACN 1212860$ °~^AT~E"T;gF~~roE"~E TAXPAYER RESPONSE r`_ ~_REV-isaa'EkxFb`~us-~„ DATE 04-30-2012 ~~-~I ' `!" ..tUi~ it CUti~1~~CR~Af~f~~ ~G , f'A STEVEN M 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 notifyethendeDaartmentnofoyour• relationship tofthetdeceased by checkingnBoxlCTin PARTllnbelowtandowritingy"spouse" bntPART lust 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 $ 38,254.34 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax y` 6,375.85 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X . 15 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 1^ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMEMT A. ^ The above information and tax due is correct. C C H E C K 0 N E ~ Remit payment to the Register a discount or avoid interest, / an official assessment will be of Wills with or return this issued by the two copies of notice to the PA Department this notice to obtain Register of Wills and of Revenue. B L 0 C K 0 N L Y B. ~he above asset has been or will b filed by the estate representative e reported and . tax paid with the Pennsylvania inheritance tax return PART If indicating a different tax rate, please state relationship to decedent: 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 ,~ PART DATE PAID C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD i 2 3 . 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I reported above are true, correct and complete o the best of my knowledge and belief. HOME ~-~ WO R K ( ~ ~ ~ ~ ~ I-I' 7 - ~ .~' -T ' I o~I TAXPAYER GNATURE TELEPHONE NUMBER DATE