HomeMy WebLinkAbout95-0297REV-1543 EX AFP (8-94) /~
CON;IONWEALTH OF PENNSYLVANIA INFORMATION NOTICE FILE N0. 21+~- 7 ~ ~~~
DEPARTMENT OF REVENUE AND ACN 95103876
BUREAU OF INDIVIDUAL TAXES TAX PAYER R E S PO N S E
DEPT. 2aabol DATE 02-16-95
HARRISBURG, PA 17128-0601
TYPE OF ACCOUNT
ESTATE OF MARIAN L WORCESTER ^ savlNCs
5.5. N0. 193-36-2593 ® CHECKING
DATE OF DEATH 10-27-94 ^ TRUST
COUNTY CUMBERLAND ^ CERTIFICATE
REMIT PAYMENT AND FORMS T0:
PATRICIA A WILLIARD REGISTER OF WILLS
247 N. 19th St. CUMBERLAND CO COURT HOUSE
CAMP HILL PA 17011 CARLISLE, PA 17013
PNC BANK has provided the Dapartaent with the information listed below which has boon used in calculating the
potential tax due. Their records indicate that at the death of the above decedent, you wore a joint owner/beneficiary of this accoun#.
If you foci this infaraation is incorrect, ploasa obtain written correction frog the financial institution, attach a copy to this fora
and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co~onwaalth of Pennsylvania.
questions aay be answered by calling (i1 /) l8i-SS23.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
account No . 514 0117 318
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rat•
Potential Tax Due
Dat• 11-01-78
Established
1,066.60
X 50.000
533.30
x .15
80.00
To insure proper credit to your account, two
C2) copies of this notice must accompany your
payment to the Rogistor of Wills. Nake chock
payable to: ^Rogistor of Wills, Agent^.
NOTE: If tax payments are made within three
(3) months of the decedent's data of death,
you may deduct a SX discount of the tax due.
Any inheritance tax due will becowe delinquent
Wino (9) months after the date of death.
PART TAXPAYER RESPONSE
:::,: ,.:
'~~.. , .,. fit... , , .~ ~.,....~:;........ ..........
A. ~ Tho above information and tax due is correct.
1. You aay choose to remit payment to the Rogistor of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or you nay chock box ^A^ and return this notice to the Register of
C 0 N E ~ Wills and an official assossaent will be issued by the PA Departaont of Revenue.
BLOCK B. ~ Tho above asset has boon or will bo reported and tax paid with the Pennsylvania Inheritance Tax return
0 N LY to bo filed by the decedent's roprosentative.
C. ® Tho above inforaation is incorrect and/or debts and deductions wore paid by you.
You gust coapleto PART 2^ and/or PART 3^ below.
PART If you indieat• a different tax eta, ploasa stet' your
~ I slat ionship to decedent : - ~l1(J~E'-r
Tax ^p?'liLR!! -- ^L•!".~L!TA,7IOr: ^r~ T~,X 0:`." .ICI`1T~7.°.:.lS? ~"CC^::!~ITS '~~D'~;
LINE 1. Dat• Established 1 11~1~78 ~'~'=~
2.
Account Balance
2
1 066.60 .
'~r,s,:::::::
i;
3. Percent Taxable 3 X 50.000
4. Amount Subject to Tax 4 533.30 ~:
':!
5 Debts and Deductions 5 - 95.00 ii!
.
6
Amount Taxable
6 438.30 5;;:~:;
s€i
.
7 . Tax Rate 7 X - 06 ~s
8 Tax Dus 8 26.30
.
PART DE8TS AND DEDUCTIONS CLAIMEI
s ,"
DATE PAID PAYEE
4,
DESCRIPTION
y3~~
:;~,.~1, ~.fj~6 ~
t:.. w
AMOUNT PAID
& Weidner Attarne Fee 95.00
IYINL ~cna~r vn ~+..~ ..r..~o.+~•••
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the bestee~~o~~~~f my knowledge and belief. HOME ( 717 ) 761-0467
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