HomeMy WebLinkAbout07-09-12BUREAU OF INDIYIDUAL TAXES I,fj (~~ FILE NO. 21 - 4~ ~ d [ ~~
Po cox zaosol p@1711S~/~V AND ACN 12113463
HARRIS6URG PA 17128-0601 DEPARTMENT OF RE -"""' ~ PAYE R RE S P 0 N S E
DATE 02-23-2012
REV-1543 E% aFP (15-lll
-9 AMIt~ 51
~ PENNSYLVANIA INHERITANCE TAX
MATION NOTICE
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'S CG/1U~,~Rcp~a
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PATRICIA L CHUBONHALL
404 S 14TH ST
HARRISBURG PA 17104-1831
EST. OF JOHN B HALL
SSN 195-36-5707
DATE OF DEATH 10-09-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SOVEREIGN BANK 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 Soint owner/beneficiary of this account. If yoU are the SpOUSe Of the
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 department of your relationship to the deceased by checking Box C 1n PAR7 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_wi th questl ons.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0351062203 Dats 11-05-1987 7o ensure proper credit to the account, two
Established copies of this notice aunt aecoapanv
Account Balance $ 8,266.06 peyaent to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxablo X 50.000
NDTE: If tax payaents are aade within th re•
Amount Subject t0 Tix $ 4 ~ 133.03 aonths of the decedent's date of death.
Tax Rate ~( , lrj deduct a 5 percent discount on th• tax due.
Arty inheritance tax due will become delinquent
Potential Tax Due $ 619.95 - nine aonths after the date of death.
PART TAXPAYER RESPONSE
0
A. ~ The above information and tax du•is correct.
Resit payment to the Registerof Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or return this notice to the Register of Wills and
C 0 N E ~ an official assassaent will be issuetl by the PA Depertaent of Revenue.
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 filed by the estate representative.
C. IYI Tha above i
`I! nforms ion is incorrect and/or debts and deductions were void.
~
2 and/or PART ~ below.
Comvleta PART
PART If indicating a different taX,-rOa~~ lease state
~~ lF~~
relationship to dacodent:
TAX RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Dato 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 DEBTS AND DEDUCTIONS CLAIMED
0
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
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