HomeMy WebLinkAbout10-05-12 (2)~ PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE FILE N0. 21 ° ~ 2-'~U~~
BUREAU OF INDIVIDUAL TAXES
PD BOX 260601 - A N D
HARRISBURG PA nlzs-o6ol ~,~~~~~_ TAXPAYER RESPONSE ACN 12150889
r~r~, ~• ~,~~"~'~ DATE 09-12-2012
i~A2 OCT -5 Pri ~~~ 51
ORPWaN`S C;+J~~S~ ~
pgERU~ND CO.. PA
PAMELA J B LEY
24 HOPE TER
CARLISLE PA 17013-8846
EST. OF GEORGE L HOLMES
SSN
DATE OF DEATH O1-2o-2012
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
WELLS F ARGO 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. 001010264504522 Date 05-19-2010 To ensure proper credit to the account, two
Established copies of this notice must accompany
ACCOUnt Balance $ 741 .00 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 370.50 months of the decedent's date of death.
Tax Rate ~( , 1~j deduct a 5 percent discount on the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due $ 55.58 nine months after the date of death.
P~T TAXPAYER RESPONSE
~ FA'#R~~~Fa..-it-ESPQ~: Y!'~ L1; 'E$t~£:.T~~~~~ 1t~ `~XC ~~s ~.TA3t; 7lE,S S T
A. ~ The above information and tax due is correct.
Remit payment to the Register of 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
0 N E 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 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 3^ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - CALCULATION
LINE I. 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
PART
a
DATE PAID PAYEE
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
3 X
4 $
5 -_~D ./.o0
6 $
.~ , P~1,;
1C ^~~'t'
~ ~~s'
y .......
Y tiw~.i..
~J -.~r...:~:.:
8 $
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
:, ;
'fem. r~' f..
AMOUNT PAID
D faa
20 !L. - O , o~ o0
v vines ~cn~cr un amine ~ yr Iax l.OmpULailOnJ $ 6r (~ vV
Under penalties of perjury, I declare that the facts I reported above are true, correct and
complete to the best of my knowledge and belief. HOME C '/' ) le7' S' 7
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TAXPAY~R SIGN/SURE TELEPHONE NUMBER DATE
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