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Home My WebLink About05-04-12~, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE PORBOX 2B060DIVIDUAL TAXES ~-- A N D F I L E N O Pennsylvania ACN HARRISBURG PA vlza-oeol oePAaTMeeroFaevenuE TAX P A Y E R R E S P O N S E DATE REV-1543 EX AFP (OS-11) 21" ~~-`~j~- 12125453 04-16-2012 EST. OF KAREN M ULSH SSN 174-46-6751 DATE OF DEATH 03-26-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: MARK S ULSH REGISTER OF WILLS 4 LANTERN LN 1 COURTHOUSE SQUARE CAMP HILL PA 17011-8456 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SUSQUEHANNA VALLEY FCU 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 y0U 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 farm and return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE STDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1049 Date 09-02-1977 To ensure proper credit to the account Established copies of this notice must accompany Account Balance $ 1 , 544.89 Payment to the Register of Wills. Mal payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made withii~ /; ^- Amount Subject to Tax $ 257.49 months of the decedent's date of deatL; ^, ~ ~ %!, Tax Rate ~( DO deduct a 5 percent discount on the tar j ~ -_; -^ . 0 0 Any inheritance tax due will become dr_- _^_ ~ ^ Potential Tax Due $ nine months after the date of death. = ~% PART TAXPAYER RESPONSE ~ v '=N=`. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT ~ s ~ O .~ A. The above information and tax due is correct. ~ ~ N - '~' i. 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 .. O N E an official assessment will be issued by the PA Department of Revenue. BLOC K ~ B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance to O N L Y filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART Z~ and/or PART 3^ below. PART TAX If indicating a different tax rate, please state relationship to decedent: RETURN - CALCULATION LINE 1. Date Established 2. Account Balance i. 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 +fi 5 6 7 X s $ OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 4 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, correct and comp e e to~ be~my knowledge and belief. HOME C ~,1 ) ~~i'`~~I~ WORK ( ) -~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S ~ PENNSYLVANIA INHERITANCE TAX ~~ ~y{~ INFORMATION NOTICE j BUREAU OF INDIVIDUAL TAXES ~~""""'""' FILE NO. 21 ~- 1 2~ ~~.~. PD BDx 266661 ennsvlvania AND HARRISBURG PA 17128-0601 ~ + ACN 12125454 oEPARTMENTOFREVEN~E TAXPAYER RESPONSE DATE 04-16-2012 REV-1543 EX RFP (05-11) EST. OF KAREN M ULSH SSN 174-46-6751 DATE OF DEATH 03-26-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: MARK S ULSH 4 LANTERN LN CAMP HILL PA 17011-8456 REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SUSQUEHANNA VALLEY FCU 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 717-787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT" INSTRUCTIONS Account No. 1049 Date 09-02-1977 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance ~` 1 , 544.89 payment to the Register of Wills. Makf payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within Amount Subject to Tax $ 257.49 months of the decedent's date of death Tax Rate X .00 deduct a 5 percent discount on the tax . 0 0 Any inheritance tax due will become de,- Potential TaX Due $ nine months after the date of death. f ^ .; d' _. PART TAXPAYER RESPONSE _ ti FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT ~ ~ ~ ~ ~~= ^; 1 A. ~ The above information and tax due is correct. ,_: -~ N Remit payment to the Register of Wills with two copies of this notice to obtain N s rl V C H E C K a discount or avoid interest, or return this notice to the Register of Wills and ~ 0 N E an official assessment will be issued by the PA Department of Revenue. _ ('~] V _ i B L 0 C K ~ g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance ta"m" ^. 0 N L Y filed by the estate representative. ~- C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X _ 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and \ com ete to th~b~f mY knowledge and belief. HOME C ) ~ ~ ,~`\NNl J~n~/~/j WO R K C ) _ ~v TAXPAYER SIGNATURE TELEPHONE NUMBER DATE DEBTS AND DEDUCTIONS CLAIMED OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PAD 1 2 3 _. ~_..d _...-. 4 5 6 7 8 TOTAL CEnter on Line 5 of Tax Computation) S ~, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21--~~ ~~ Po eox zao6ol pennsylvania ACN 12125455 HARRISBURG PA l~lza-o6ol oEanaTMENroFaEVENUE TAX P AY E R R E S P O N S E DATE 04-16-2012 REV-1543 E% AFP (05-11) TYPE OF ACCOUNT EST. OF KAREN M ULSH ~ SAVINGS SSN 174-46-6751 ~ CHECKING DATE OF DEATH 03-26-2012 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: MARK S ULSH REGISTER OF WILLS 4 LANTERN LN 1 COURTHOUSE SQUARE CAMP HILL PA 17011-8456 CARLISLE PA 17013 SUSQUEHANNA VALLEY FCU 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 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1049 Date 09-22-1977 To ensure proper credit to the account *~~ EStabli5hed copies of this notice must accompany Account Balance $ 4 ~ 074.07 payment to the Register of Wills. Mal payable to "Register of Wills, Agent" Percent Taxable X 16.667 NOTE: If tax payments are made wit hi ~ Amount Subject to TaX $ 679.03 months of the decedent's date of deat- Tax Rate ~( ~ ~~ deduct a 5 percent discount on the tam J ^ • O O Any inheritance tax due will become d'' ~ ~ Potential Tax Due $ nine months after the date of death. r ~ --. P 1Rr TAXPAYER RESPONSE J ^ ~ ^~ ^ ~s_ FAILURE TD RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT ~x ~ r,z ~:_ N `~ A. The above information and tax due is correct. ~ /_% rl ~. Remit payment to the Register of Wills with two copies of this notice to obtain ~ "~ ~- " N x C H E C K a discount or avoid interest, or return this notice to the Register of Wills and _ ~-' r 0 N E an official assessment will be issued by the PA Department of Revenue. [ B L 0 C K ~ g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tzy .. 0 N L Y filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 2 $ a X 4 +t 5 - 6 ~ X 8 PAD 1 2 3 4 5 6 7 8 OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PART DEBTS AND DEDUCTIONS CLAIMED 1DIAL CEnter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I reported above are true, corrjeQc~t~/and comp t th.e~ my knowledge and belief. HOME C /11 ~ ,7(fJ~ I Dy1J 1^X/~// WORK ( ~ '-,~ ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID