HomeMy WebLinkAbout05-23-12 (2)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 ~•
HARRISBURG PA 17128-Obu•]j~( ~~ ~F. A ~ - ,`-
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JOSEPHINE ~ CQ, P
24 LONGVIEW DR
MECHANICSBURG PA 17050
PENNSYILVANIA INHERITANCE T
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 - I ~ - ~' `~ ,~~_
ACN 11112976
DATE 02-24-2011
EST. OF JOSEPH R STILLSON
SSN
DATE OF DEATH 08-02-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIGN BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account.
If you feel 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. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717? 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1684070694 Date 05-21-2009
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 56 036.37 payment to the Register of Wills. Make check
~ payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to TaX NOTE: If tax payments are made within three
$ 9,339.58 months of the decedent's date of death,
Tax Rate X . 15 deduct a 5 percent discount on the tax due.
Potential Tax Due ~` 1,400.94 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
a
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 check box "A" and return this notice to the Register of
0 N E
~ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K
0 N L Y g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance T
t
to be filed by the estate representative. ax re
u
rn
C. The above infor~ms zon is incorrect and/or debts and deductions
Complete PART
and/or PART were paid.
~ below.
u
PART
ar inaicaiing a olfferent tax rate, please state
relationship to decedent: ~~i ~C''"-'
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
3 X / i- , /~ "7
4 S ~ 3;-3~ <) s~
5 -
6 $ 3~ 9r S~
7 X ~ 1,, ,
s $ ~ --
PAD
1
2
3
4
5
6
7
8
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
PART
0
DEBTS AND DEDUCTIONS CLAIMED
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
comp to to the best of my knowlegge and belief. ~
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TAX VER SI NA URE ~ TELEPHONE NUMBER DATE~i
DATE PAID PAYEE DES['RTPTTf1N ....,,...r ... _..