HomeMy WebLinkAbout06-21-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAxES -,- INFORMATION NOTICE
Po eox zsocol r'C~`~"-'?i''~`': (~rM FILE N0. 21 12-0321
HARRISBURG PA 17128-0601 ~i_V~~. ~- ~- AND
L TAXPAYER RESPONSE ACN 12502693
REV-1543A pFP (7-p01 DATE 06- 15-2012
~:~~ f fi ~~~ ~ t ~~ i2~ 24
CU~BEPLW"°~[~ CC., PA
MARIA DICKERSON
APT 107
9659 MANASSAS DR
MANASSAS PARK VA 20111-8032
TYPE OF ACCOUNT
EST. OF HARRY D JONES ~ SECURITY
DATE OF DEATH 02- 24 - 2012 ~ STOCK
COUNTY CUMBERLAND ~ BONDS
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
VANGUARD
calculating the potential tax due. Their recopdsvindidcate that ratethewdeathhofltherabovendecedentbelow which has been used in
If you feel this information is incorrect, please obtain written correction from the transfer agentyoattach a ~opyftolthisoformlandsset.
return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania.
Questions may be answered by calling (717) 787-g3Z7,
COMFI.ETF FART 1 BELOW * ~ * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 09892445777
To insure proper credit to your account, two
(2) copies of this notice must accompany your
DOD Valuation 30,695.58 payment to the Register of Wills. Make check
Percent Taxable payable to: "Register of Wills, Agent".
X 100.00
Amount Subject to TaX 30,695.58 NOTE: If tax payments are made within three
TaX Rate (3) months of the decedent's date of death,
X . 1 5 You may deduct a 5% discount of the tax due.
Potential Tax Due 4,604.34 Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
TAXPAYER RESPONSE
FAILURE TO 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
C C H E C K a discount or avoid interest, or you may 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 B. ~ The above asset has been or will be re orted and tax
O N L Y p paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
PART If
C. ~ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
you indicate a diffierent tax rate, please state
relationship to decedent: Your
TAX RETURN - COMPUTATION
LINE 1. DDD Valuation
2. Percent Taxable
3. Amount Subject to Tax
4. Debts and Deductions
5. Amount Taxable
6. Tax Rate
7. Tax Due
PART
0
OF TAX ON ABOVE ASSETCS~
1
2 X
3
4
5
6 X
7
PAD
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
5
7
8
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) g
Under penalties
pr~ ete to the best of perjury, I declare that the facts I have reported above are true
my kn/o~Wledge~ajnd belief.
~7., , correct and
RK C ~
TAXP YER SIGNATURE ! ~ -/,
I / ~ ,
TELEPHONE NUMBER DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REGISTER OF WILLS
NO. CD 015979
DICKERSON MARIA
9659 MANASSAS DRIVE #107
MANASSAS, VA 20111
-- -- ,~~~
REMARKS: MARIA DICKERSON
CHECK#528
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 54,374.12
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY:
REV-1162 EX(11-96)
54,374.12
GLENDA EARNER STRASBAUGH
TAXPAYER
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