HomeMy WebLinkAbout06-20-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
Po eox zao6ol
HARRISBURG PA 1712s-0601
~ I~~`(~~
, ,~'v,~• s
~- ~•: ;,.,, ~
, ,4~yG ~'`~ ~; +• --~••-
~~ REV-1543A AFP (7-00)
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 12-0321
ACN 12502694
DATE 06-15-2012
~~~~ ~~~ ~O ~~~ ~. 2-~ TYPE OF ACCOUNT
~ EST. OF HARRY D JONES ^ SECURITY
$,S, N0 . 175-18-2025 X^ sEC AccT
t' '° ~ DATE OF DEATH 02-24-2012 ^ srocK
QR~'~",t~~ `~ "'~~~~
PA
R~D C0 COUNTY CUMBERLAND ^ soNDs
,
CUM~ REMIT PAYMENT AND FORMS T0:
SALLY J CURRIE REGISTER OF WILLS
398 ADAMS RD 1 COURTHOUSE SQUARE
CARLISLE PA 17015-9347 CARLISLE PA 17013
VANGUARD has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset.
If you feel this information is incorrect, please obtain written correction from the transfer agent, 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.
puestions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 88007384039 To insure proper credit to your account, two
<2) copies of th15 notice must accompany your
payment to the Register of Wills. Make check
DOD Valuation 16 ~ 151 • 94 payable to: "Register of Wills, Agent".
Percent Taxable X 100.00
NOTE: If tax payments are made within three
Amount Subject to Tax 16 ~ 151 • 94 (3) months of the decedent's date of death,
you may deduct a 5% discount of the tax due.
Tax Rate X . 045 pny inheritance tax due will become delinquent
Potential Tax DUe 726 • $4 nine C9) months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TD RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
A. ^ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
C 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 to be filed by the decedent's representative.
C. ^ The above information is incorrect and/or debts and deductions were paid by vou.
You must complete PART 2^ and/or PART ^3 below.
PART If you indicate a different tax rate, please state your OFFICIAL USE ONLY ~ ^ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE ,\,
TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S~ PAD
LINE 1. DOD Valuation 1 I
2. Percent Taxable 2 X 2
3. Amount Subject to Tax 3 3 -
4. Debts and Deductions 4 - 4
5. Amount Taxable 5 5
6. Taz Rate 6 X 6
7. Tax Due 7 7
8
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) S
Under penalties of perjury, I declare that the facts I have reported above are ect and
true, co r^^
complet to the besq~ of my ..knowledge and belief. HOME C, ~~ ) ~ ~ ~, ~~ JJ
(J`
A~~I~~ wo R K c ~
TAXPAYER SI N TU E TELEPHONE NUMBER AU TE