HomeMy WebLinkAbout04-27-12~ PENNSYLVANIA INHERITANCE TAX
/v .~~N~QRMATION NOTICE FILE N0.21-1/--105/
BUREAU OF INDIVIDUAL TAXES ~1 ~r`~~ ~i ;~~-~w !!''
PO BO% 280601 pennSy Y~ ~ ~. ,, AND ACN 12125496
HARRISBURG PA 17128-0601 DseAaTmervT Or r~SSferw~ ~. -!,=~~PAYER RESPUNSE DATE 04-16-2012
9EV -]S YI EX X.FP [95-111
ROBERT MANN
C/0 HOLLY RITCHEY
1204 ALLENDALE RD
MECHANICSBURG PA
[~a2~iPR27 AF911~08
CLERK Of
ORPHAN'S COURT
CLIMRFRI AN~~ CO PA
17055-4407
EST. OF HELEN L MANN
DATE OF DEATH 03-10-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17813
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
CITIZENS BANK OF PENNSYLVANIA provitled the department with the information below. which was used in calculating the inheritance tax due.
Re COrtls intli to to that at the death of the above-named dece tlent, you were a joint gNner/beneficiary Of thi~.; account. IP yoU are the spOUSe of Lhe
deceased and any amount other than zero 1s reflected below on the Potential Tax Due line. note no tax may be due, but you must
notify the deoa rtment of your relationship to the deceased by checking Bax 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 cDDY to this form antl return
it to the above address. Please call Ill-7 H7-8327 with questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6100582701 Date 09-05-1995 To ensure Draper cratlit to the accounk, two
Establishetl coo ies of this notice oust aceonpanv
Dayn enY Yo the Regi sker of Wills. Make check
Account Balance ~` 2,702.73 Dav able to '•Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If kax pavnants are natle within three
Amount Su bd ect to Tax $ 1 r 351 .37 nonths of the decetlent's data of death,
Tax Rate )( , 1 5 tleduct a 5 percent dirt punt on the tax due.
Any iMertance tax due will become tlelinauent
Potential TaX Dua ~ 202.71 nine nonths after the tlate of tleakh.
PART TAXPAYER RESPONSE
1^
A. ~ The above inf ornaiion and tax due is correct.
Remit Dayn enk to the Re ei ster of Wills with two copies of this notice tD obtain
a tli scount or avoitl interest, or return this notice to 4ha Register of Wills and
CHECK an otf icial assessment will be issued by khe PA De partment of Revenua.
ONE ~
BLOC K B. ~ The above asset has been or will ba reported and tax p aid with the Pennsylvania inheritance tax return
ONL Y filed by the estate representative.
C. ~ The above inf orna >.on is incorrect and/or debts and deductions were paid.
Complete PART ~2 antl/or PART a^ below.
PART If indicating a different kax
relationship to decetlent:
TAX RETURN - CALCULATION
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
please state
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
x X
5
6
penalties of perjury, I declare khat the facts I reported above era true, corr t and
ty to k b of my nowledge and bell ef. HOME C ~)
WORK ( )
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IGNFC~RE TELEPHONE NUMBER DAT
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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