HomeMy WebLinkAbout07-09-12 (2)BUREAU OF INDIVIDWL TAXES
PO BOX 290601 pennsyly~
HARRISBURG PA 17128-0601 DEPARTMENT OFR ~
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PENNSYLVANIA INHERITANCE TAX ~/ ~1
INFORMATION NOTICE FILE N0. 21 - Ja_ ~'/%/
AND ACN 12113464
~'~ AYER RESPONSE DATE 02-23-2012
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2012 JUL -9 AM I I ~ 5'
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EST. OF JOHN B HALL
SSN 195-36-5707
DATE OF DEATH 10-09-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
PATRICIA L CHUBONHALL REGISTER OF WILLS
404 S 14TH ST 1 COURTHOUSE SQUARE
HARRISBURG PA 17104-1831 CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIGN BANK provided the department with the information below. which was used fn calculating the inheritance Lax due.
Records indicate that at the death of the above-named decedent. you were a ,l Dint owner/beneficiary of this account. Ii y0U ere the Sp0U5e Of the
deceased and any amount other then zero 1s reflected below on the Potential Tax Due line. note no tax may be due. but you must
notify the departaw!nt of your.relationshtp to the deceased by checking Box C in PART 1 below aml writing "spouse" in PART 2.
If you believe the information is incorrect. Dtease obtain written correction from the financf al institution. attach a copy to this form and return
7t t0 the shove address.. Please call 717-797-8327 with Oues ti ons- _ ~.r t-~.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILINS AND PAYMENT INSTRUCTIONS
Account No. 0464024983 Date 10-29-1992 7o ensure proper credit to the account, two
Established copies of this noti ca wust accowparo
pavwent to the Register of Wills. Mak• check
AccOUnt Balance ,~` 1 , 066.95 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE, If tax paywents are watle within three
Amount Subject to Taz ~ 533.48 wonths of the decedent's data of death,
Tax Rata ~( 1rj deduct a 5 percent discount on the tax due.
Aro inheritance tax due will becawe delinquent
Potential Tax DUO ~ 80 • 02 nine eonths after the date of death.
PART TAXPAYER RESPONSE
A. ~ The above infonation end tax due is correct.
Rewit paywent to the Register of Wills with two copies of this notice toobtain
e discount or avoid interest, or return this notice to the Register of Wills and
C H E C K an official assesswent will be .issued by the PA Departwent of Revenue.
C ONE ~
BLOCK B. ~ Tha above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
ON L Y filed br the estate representative.
C. a above i nf or a ion is incorr and/or debts and deductions were paid.
3
owplete PART 2~ below.
and/or PART
PART If Sndleatin9 a different tax ra~ya, please state
relationship to decedent: S ^ ~ E~ ~F
TAX RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 $
3. Pareant Taxable S 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
^3
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
i
,
Under penalties of perjury, I daclar• that the facts L reported above are true, correct an d_ '~~
omplete to the best of my knowledge and belief. HOME C~(l Ul ) -tb~~ ~1~~0 y
~~ WORK C )
AXPAYER S TORE TELEPHONE NUMBER DATE