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Home My WebLink About05-21-12BUREAU OF INDIVIDUAL TAXES PD sax zeosol HARRISBURG PA 1]128-0601 OEPFPTMENT nF fl YEV -]54l EY /.FP PENNSYLVANIA INHERITANCE: TAX INFORMATION NOTICE FILE NO. 21 '~ ~~ (~~ •! ~1~ AND ACN 12129514 PAYER RESPONSE DATE 05-03-2012 ~:~i2nar2i ~~ ~: iy ni rn~. ... ORPHAN'S ~v~Ri' CUMBERLAND CO., PA JANET C ROBERTS 109 WALTON ST LEMOYNE PA 17043-2023 EST. OF GREGORY C SCOTT SSN 209-46-1581 DATE OF DEATH 04-17-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provi tletl the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the abov e-named decedent. ycu were a joint owner/beneficiary of this attoun t. 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 tle artment of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe ~he information is incorrect, please cotain written correction from the financial institution, attach a copy to this form and return i[ to the above adtlress. Please call 717-787-8327 with Quests ons. COMPLETE PART 1 BELOW ^ S@Er ^R EVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 114574-05 Date 06-16-2007 To ensure proper credit to the account, two Established copies of this notice oust accompany A<counk Balance 3 962 65 pavne nt to the Resist er of Wills. Make check , . pav able to ''Register of Wills. Apant". Percent Taxable X 50.000 Amount Subject t0 T8X S` 1 981 33 NOTE: If kax payments are made within three , . months of the decedent's tlate of death. Tax Rate X , p G 5 deduct a c. percent discount on the sax tlue. Pots nisei TBX Due g 89 16 Amr inherit ante tax tlue will become delinquent . nine nonthis after the tlate of death. A. ^ The above information and 4ax tlue is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoitl interest, or rat urn this notice to Me Resister of Wills and ONE an official assessment will be issued by the PA Oepa rtmeni of Revenue. BLOC K B. ~ The above asses has been or will be reporietl antl tax paitl with the Pennsylvania inheritance tax return ONL Y tiles by the estate representative. C. ~ The above inf orna ton is incorrect and/or debts and tletluctions wa rc~ paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state relationship tp tlecatlent: 7AX RETURN - CALCULATION LINE 1. Data Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts antl Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART DATE PAID PAYEE OF TAX ON JOINT/TRUST ACCOUNTS 2 $ 3 X 4 +S ] X e $ DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID Untlar penalties pf perjury. I declare that the facts I reported above are true, correct antl cpmpleta to the best of my knowletlge and belief. HOME C ;I WORK ( ) TAXPAYER SIGNATURE TELEPHONE Nl1MBER DATE , BUREAU OF INDIVIDUAL TAXES PO BOX 280681 pennsfr{[i~ HARRISBURG PA 17128-0601 DErexTMENr Q 1(F t lUE R , ~ f ~ REV-1543 E%f ~l{~)1 PENNSYLVANIA INHERITANCE TAX ~~ll INFORMATION NOTICE FILE No. 21 ~ dl - ~' =rl`~E~-XPAYERNRESPONSE AcN 12129513 ~~ ~~7. DATE 05-03-2012 ,., y+ i ~'12F9AY2t Phi i~ 15 ORFti«fCV J vUURT CUMBERLAND CO„ Pq JANET C ROBERTS 109 WALTON ST LEMOYNE PA 17043-2023 EST. OF GREGORY C SCOTT SSN 209-46-1581 DATE OF DEATH 04-17-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the tlepartment with the information below, which was usetl in calculating the inheritance taz due. Records indi cats that at the tleath of the above-named decetlent. you were a joint owner/beneficiary of this account. If yoU are the 8p0U8e Of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no taz 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 ropy to thfs form and return it to the above atltlress. Please call 717 -]87-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS account No. 114574-11 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 05-16-1990 Established $ 2,702.63 X 50.000 $ 1,351.32 X .045 $ 60.81 To ensure proper cretlit to the accounk, two copies of this notice gust accomoanv payment to The Resister of Wills. Make check payable to "Rani star of Wills. Arent". NOTE: If tax pavnanks are Wade within three months of the decetlent's date of tleath, detluct a !i percent discount on the Tax tlue. Aro inheritance Tax due will become delinquent nine months after the tlake of death. PART TAXPAYER RESPON SE t^ A. ~ The above inforoation and Tax tlue is Correct. Remit payment to the Resister of Wills with two conies of this notice to obtain CHECK a discount or avoid interest. or return This notice to the Resister of Wills antl an official assessment will be issued by the PA Department of Revenue. ONE BLOCK B. ~ The above assek has been or will be reported and tax paitl with the Pennsylvania inheritance tax rekurn ONL Y filetl by the estate representative. C. ~ The above info roa ton is incorrect and/or debts and tleductions were paid. Complete PART ~ antl/or PART ~ below. PART If intlicatins a tlifferent tax rake. please stake relationship to tlecedent: 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 Sub3ect to Tax 4 $ 5. Debts and Deductions 5 6. Amounk Taxable 6 +fi 7. Tax Rate 7 X 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED ^3 Untler penalties of perdury, I tlaelare that the facts I reported above are true, correct and complete to the best of my knowletlse and belief. HOME C ) WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID ;' ;.-~1CE. `~~' a ~,~E., _~ ~.' ~ ~ ' _~ m w ~ `" O a ,~ ~ ~ ~` 1~r Y"' Y r N y ~ ~ ^'aY1 .,o~G+. N u~ U z ~~ s~ w N ~~~^$ a- Z o ~ ~~ O r G V • ~~ V ~~ . w :- ~~ ~ ~ M ~ ~ b ~ =o z yf r dS ~ N ~ WY, 6~ O 6 ~ ~ry^' o ~ _ ~." G l 9 W ~- _~ 1b a~3 "t ?is d pr ,, r~: ~.; ,; ` 4, "~. V~ '~~ '.~ ~. ill ,~ .~.; x. a 0 N ~ ~ V ~v~d , m ~ o °" > o ~ of +. a ~. o ~~ ~ ~ o ,a ~;~ ~~- z~' ~8a f , rlt~E C1F i)F ';1~? LS~ _,(21 PFD CLEF' fl .~ ~• _~ ~i i ~ .mac V 0 r-+ ~~' m m m .. x'? ~r w d /'^ H 0 U