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Home My WebLink About06-19-12'~ PENNSYLVANIA INHERITANCE TAX r BUREAU DE INDIVIDUAL TAXES ~~' ~ INFORMATION NOTICE FILE No.~~ Po Box zso6ol PennsY~V 8' ~ 'ifs. OF AND ~~~ ~~,~ HARRISBURG PA 17128-0601 pEPARTMENTOFR~~E.__ - `',ji~A~XPAYER RESPONSE ACN 12128853 _.v~ DATE 04-30-2012 REV-1543 EX AFP (D5 -I1) ~(~~Z ~U'~ ~ 9 TYPE OF ACCOUNT EST. OF RUTH M CARLS ~ SAVINGS SSN 577-36-6085 ~ CHECKING DATE OF DEATH 04-04-2012 rRUST o~N ~_< < ~ ~ : ^ CtIPL~acf~( q~iD ~`'vr~' COUNTY DAUPHIN ~ CERTIF. -/'VV 1.io" ~ REMIT PAYMENT AND FORMS T0: BARRY P CARLS REGISTER OF WILLS 801 KECKLER RD FRONT AND MARKET ROOM 103 HARRISBURG PA 17111-3168 HARRISBURG PA 17101 MID PENN BK 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 Sp0U5e 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 717-787-8327 with questions. COMPLETE PART 1 BELOW * S~E REVERSE SIDE FOR FILING ANI1 PAYMENT I~STRUCTiONS Account No. 6021612 Date 12-07-2010 To ensure proper credit to the account, two Established copies of this notice must accompany 91 , 854.27 Payment to the Register of Wills. Make check Account Balance $ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax ~` 15,309.35 months of the decedent's date of death, Tax Rate X . 045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 688.92 nine months after the date of death. PART TAXPAYER RESPONSE 1^ 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 C 0 N E ~ an official assessment will be issued by the PA Department of Revenue. B L 0 C 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 information is incorrIe~c-t~ and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: 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 OF TAX ON JOINT/TRUST ACCOUNTS 1 2 $ s X 4 5 6 `~ 7 X 8 $ OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 __~___~-_., r+ 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, co/rrect and co_mplete~jto the b~fest of my knowledge and belief. HOME C ) + ~`i ' ~y~~ L~- ~~1 ~c"+~/ WORK C ~ ~~. !l. TAXY21~fER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S c ees x iy~ r .r s_a 8 ~ - '~. ., , r David E. Gruver, Pa. C.P. Paralegal Direct Dial: 717.237.5362 Direct Fax: 717.260.1658 dgruver@mwn.com June 18, 2012 Cumberland County Register of Wills 1 Courthouse Square Carlisle, PA 17013 RE: Estate of Ruth M. Carls File No. 2112-0435 DOD: April 4, 2012 Dear Sir or Madam: The enclosed Pennsylvania Inheritance Tax Information Notice for the above-mentioned individual was reported under Dauphin County. The decedent was a resident of Cumberland County when she died. I have enclosed the notice for filing in Cumberland County. Please date-stamp our file copy and return it to me in the envelope provided. Please contact me with any questions. Thank you. V y trul .yours, ~ ~~,-~ `'6a~E. ~vrer, ~ C`am` Paralegal deg Enclosures c: Barry P. Carls ~ U p..,7 ; ~ ~ r , :z, m ^° ` - ~ ~ ~~' --~ , - ,~,, ; - xr - _ n ~ -Q - ~ T- ---~ rv ;- ;..-- tv ~~ p t,c~ '~ www.mwn.com ~~. ~ , , ~ ,. ,;r;~~ ~~"x ~~~ `~ ~;, ~' ~ - r ~ ~ r ~ ~ ~ .[ ~ 4 k 4 ~ . ~. '" y ~ ~ r ,~` ~ e r~' ., .y R, .~ __', vi N ~ ~, N ,_~ ,:' ° .. ~, rn :~; ~,~ c ~ "" ~ ~ -} _`'i-~ ,' ~~ `'z; S cam, ~ N \_ ^L W ~~ .~ ^,~ W Xi~ Lj ~ o a~~ ~ ~ ~ aQ a~ .~ ~ ~~ U U ~ `~ U ~~/I '`` ~/ F.a ~/ ~i/ ~ V ~` ~~ ~~ a e~ • ~. ~"•,~ .~ :; .~. :~~ ~.