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HomeMy WebLinkAbout04-20-12 (2)~ ~~ PENNSYLVANIA INHERITANCE TAX BUREAU DF INDIVIDUAL TAxES ~ ~ INFORMATION NOTICE AND ' FILE N0. 21 ~. ~~~~ PD Box zsocol pens • ~ljdii HARRISBURG PA 17128-0601 ~ •~ ~~r ; .,~~-j'i~ ACN 121221 DEPARTME EN~,.E- tn; ~;;~ ; TAXP AYER RESPONSE DATE _ 03 29-2012 REV-1543 E%~AFP ~i15 -.11) ~,~ TYPE OF ACCOUNT `~'~ ('~Clt~ ~'~ ~~'~ ~`~ i ~ EST. OF MARY I BOONE ^ savlNGs $SN 186-24-9281 ~ CHECKING ~' ~ '' VLEr;K •~.:` DATE OF DEATH 11-09-2011 TRUST ^ O~~}-{j=',~` j '~'~JF~T COUNTY CUMBERLAND ^ CERTIF. C~~~~~~~~'~ ;•'.P`a~ ~ ~•~~~ ~ ~Q. REMIT PAYMENT AND FDRMS T0: MARILYN L SHEARER REGISTER OF WILLS 924 W TRINDLE RD 1 COURTHOUSE SQUARE MECHANICSBURG PA 17055-4091 CARLISLE PA 17013 SOVEREIGN BANK 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-/87-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2331032939 Date 04-23-1983 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 8 4 1 0 . 9 5 Payment to the Register of Wills. Make check $ ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three AmOUnt Subject to Tax $ 4,205.48 months of the decedent's date of death, TaX Rate X , 15 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 630.82 nine months after the date of death. PART TAXPAYER RESPONSE 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 H E C K a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ONE BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicatins a different tax rate, please state OFFICIAL USE ONLY ^ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 +fi 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 'fi b 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and ~ ` complete to the bes#,of. knowledge and belief. HOME C ~ ~~ f ^~/ ' ~~ . • ~~ /' WORK C ) ~~.~~ TAXPAYE - IGN URE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S