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Home My WebLink About09-12-12~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE r BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PennsylvaENU-' ,`,~~~,~ ~~~(('~~ r~~ ~I~1S~G~S~ REV-1543 EX AFP (05-11) ~ "('•~J FILE N0. 21 12-0832 ACN 12143136 DATE 08-30-2012 ~~+l~ ~~~ ~ 2 P4.., ~` ~ ~ST. OF EMMA M TRITT SSN 204-03-9961 ' DATE OF DEATH 07-14-2012 U,lk'~y'`f' ~``' v~F~Si COUNTY CUMBERLAND CUN!BERL.~D CO, PA REMIT PAYMENT AND FORMS T0: JANE HIPPENSTEEL REGISTER OF WILLS 52 ASHTON ST 1 COURTHOUSE SQUARE CARLISLE PA 17015-6914 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. 0 RRST OWN 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 joint owner/beneficiary of this account. If you are the 5p0u5e 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. 4000037550 Date 05-04-2010 To ensure prover credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $` 9,604.44 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax ~` 4, 802 • 22 months of the decedent's date of death. Tax Rate ~( . 045 deduct a 5 percent discount on the tax due. Anv inheritance tax due will become delinquent Potential Tax Due $ 216 • 10 nine months after the date of death. PART TAXPAYER RESPONSE FIIILI~RE TO ESPONII WILL RES\~\LT I~°AN~O~F~ICI~1L TAX ~1SSESS,NfklT A. ~ The above information and tax due is correct. 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 an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C 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. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~2 and/or PART ~ below. PART 2^ If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. 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 PAD 1 z $ 3 X 4 +~ 5 - 6 7 X 8 $ ~~ OFF,ICIAL US~~~~~LY ~~ AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 PART DEBTS AND DEDUCTIONS CLAIMED ^3 TOTAL (Enter on Line 5 or pax compuca a one a Under penalties of perjury, I declare that the facts I reported above are true, correct and co lete to the est of my knowledge and belief. HOME C ) WO R K C ~ ) ~~~ - Q ~~'~ T PeVFR crrNe IRF TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE No. 21 12-0832 BUREAU OF INDIVIDUAL TAXES Po Box zao6ol pennsy~~~~ ~ ~''`C a EAND ACN 12145415 HARRISBURG PA 17128-0601 DERARTMENTOr,~nevFwue , ~\JL~~EV1S~ ~~~~L~S~ tt~~ * * * DATE 08-30-2012 REV-1543 E% AFP~[OS-I~i) ~ ~ I ~~ ~~~ J ~ ti`,fi?Z ScP f 2 P~~ 2~ ~$ Gt~i'H~~~l' ~ ~~Jur~~ cu~~~~«a co., PA JANE HIPPENSTEEL 52 ASHTON ST CARLISLE PA 17015-6914 EST. OF EMMA M TRITT SSN 204-03-9961 DATE OF DEATH o7-14-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FDRMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. CITIZENS BANK OF PENNSYLVANIA 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. 6252143953 Date 04-14-2008 To ensure prover credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance ~` 3 ~ 367.75 payable to "Register of Wills, Agent". Percent Taxable X 50.000 .NOTE: If tax payments are made within three Amount Subject to Tax ~ 1 , 683.88 months of the decedent's date of death, TaX Rate )( .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential TaX Due $ 75 • 77 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RES'ULT~IN AN OFFICIAL TAX ASSESSMENT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Register of Wills and C H E C K an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~he 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. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART a below: PART If indicating a different tax rate, Please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OFFICIAL USA ONLY PA DEPARTMENT OF REVENUE OF TAX ON JOINT/TRUST ACCOUNTS PAD 1 2 s X 4 $ 5 6 '~ 7 X 8 1 2 3 4 ,. 5 6 7 PART DEBTS AND DEDUCTIONS CLAIMED ^S (DIAL Ltncer on Llne 7 yr ,a,c w mNU~a ~i.,ni Under penalties of perjury, I declare that the facts I reported above are true, correct and comp ete to the b st of my knowledge and belief. HOME C ~ ) WORK C ~~ ) ~ - ~ ~I'~/~l TA AYER IGNA E TELEPHONE NUMBER DATE ^ATE PAID PAYEE DESCRIPTION AMOUNT PAID