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HomeMy WebLinkAbout02-13-13 (2)BUREAU OF INDIVIDUAL TAXES PO BOX 280661 HARRISBURG PA 17128-8601 pennsytvania bEPRRTMENT OF REVENUE REV~1 a6a EY 1FP IBS -EI) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE NO. 21 AND ACN 12137567 TAXPAYER RESPONSE DATE Ob-25-2012 SUSAN SHENK 217 EVERGREEN RD SHERMANS DALE PA 17090-8105 EST. OF ROBERT S GREENS SSN DATE OF DEATH 05-26-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17813 TYPE OF ACCOUNT SAVING CHECKI TRUST © CERTIF M & T BANK provitletl the tlepa rtment w7tn the 7nforma t7 on Below. which was used in calculating the inheritance tax tlue. Records intli Cate Lhat at the tlea th oT the above-named tlecetlent, yqU Were a 3g1nt owner Poenefi ci dry of this attpUnt. S1 y0U are the 5p0U5e bf the deceasetl and any amount other than zero 1s reflected below an the Potential Tax Due line, note no tax may be due, but you must notify the deyartment of your relationship to the tleceased by checking Box C in PART 1 below and Wrlting "spouse" 1n PART 2. If you bet cave the lnfbrmati on is incorrect, please obtain Written correction from the finand al instttud on, attach a copy to this form antl return it to the above address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW W SEE REVERSE SIDE FOR FILING AND PAYMFN_T INSTRUCTIONS Account No. 31003917889247 Date 11-14-2008 To ensure proper credit to the account, two Established copies of this notice wust accowpanv 26 3.34 paywont ko the Re6i st er o4 Willz. Make chock Account Balance ~` 1DE pav able to "Register of Wills, Aaent•'. Percent Taxable X 16.bb7 NOTE, If tax paynents are wade within three Amount Subject to Tax f 1 E710.59 wonths of the decedent's date of death, Tax Rate X 12 deduct a 5 percent discount on the tax due. Aro inheritance tax due will bacowe delinquent P otent181 Tax Due ~ 205.27 nine wonths after the date of death. PART TAXPAYER RESPONSE - A. ^ The above inferwat ion antl tvc due ds correct. C r-`u m m n Rowit paywenk to the Raeister of Wills with two copies of th $,n ca to ob~in ~ CHECK ~ a discount or avoid into rest, or roturn this notice to the Res of Wil[71and l~ r ~ ~ an off ie ial as sasswent will be issued by the PA Devarbant oT7Rea~a ' I ONE ~ L BLOCK B. 7D yr 1-E ~ The above asset has bean or will be reported antl tmc oaid with tnPyinsgd aniZ~sanhar~E~ tax rata rn ONLY filed bW the .eta. r.p~eaantatlv.. (/I ~ 2 ,'K p O C. ~ The above inf orwa ion is incorrect and/or debts end detluctions we~ A'al dR,y ~ ~ ~ Cowplete PART ~2 and/ar PART 3~ below. f7 O 'r7 ~ ~ ~ W-. C - n PART If Sndicatin9 a different tax rate, plo ase state relationship to decetlent: __ TAX RETURN - CALCULATION OF TAXON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Adeount Balance 2 3. Percent Taxable 3 X 4. Amount Subd e<t to Tax 4 5. Debts and Detlu<tfgns 5 - 6. Amount Taxable 6. $ 7. Tax Rate 7 'X ' 8. lax Due 8 PART -ucn 1 u n DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on LSne 5 of Tax Computation) t Under penalties of De ryury, I decla re .that the facts I reported above are true, correct antl e o/m/ylet• to th bast my /k owlatlge antl belief. HOME t ) 1LL/t~YJ// _ .~®/l/ WORK ( ) TAX A E SIGNATURE TELEPHONENUMBER AT BUREAU OF INDIVIBUAL TAXES PD BOX 280601 NARRI SBURG PA 11128-0601 Pennsylvania DEPARTMENT OF REVENUE REVd 5f3 EY 1FP <YS-lp PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 AND AGN 12137586 TAXPAYER RESPONSE DATE 06-25-2012 SUSAN SHENK 217 EVERGREEN RD SHERMANS DALE PA 17090-8105 EST. OF ROBERT S GREENE DATE OF DEATH 05-26-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINE ® CHECKI TRUST CERTIF M & T BANK Drovi detl the department withthe info rmati en below, which was usetl in calculatl ng the inheritance tax due. 0.e cords indicate that at the death of the above-nametl decedent, you Nere a 7o1 nt owner/benefi Clary of this account. It yaU are the SDOUSe of the deceased and any amount other than zB ro 75 reflected be1oW on the Potential Tax Due line. note no tax may be due, but you must notify the department of yourrelati ens Mp to the deceased ey chec king BOx C In PART 1 below and Writing "spouse" 1n PART 2. If you believe the lnfprmatl on is incorrect. Dlease obtain written correction from the financial institution, attach a copy tD this form and return it to the ahoae address. Please call 717-701-0327 with puestions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1292978 Date 04-01-1996 To ensure proper credit to the account, two Established copies of this notice oust accompany Account Balance ~` 29 868.84 paywan! to the Rapister of Wills. Make check r payable to "Register of Wills. Ag en t•'. Percent Taxable X 50.000 NDTEr If tax paywents are aada within three Amount Sub]ect to Tax g 1Gr934.42 wonths of the decedent's data of death, Tax Rate )( , 12 - deduct a 5 ba rcant discount on the tax due. Ary inheritance tax due will baeowe delinquent Potentfal T8X Du• ~` 1.792.13 nine wa nths after the data of death. PART T XPAYER RESPONSE 0 A. ~ Tha above. inf orwation and tax due is correct. '~~1 ~ o ti ce !o obiaan ~ istar pf Wills with two copies of thi it ent t kha Ra R ~ p ew pavw B m ' ' ~ CHEC K T nd m ~ a discount or avpid interest, or rat~rn this notice to the Rep}Sta^r of Will~ t f G'7 { I ONE v P. Ne. T_ o an official asseaswent will be. issued bv. iha Pp Oepartwen ~ ~ IL BLOCK B. I9J The above as sat has bean or will be reported and tax paid with th~ao~y~+pnia~l ho ri~c7¢~t ax return frT ti + e lf.-f . D NLV nta va. ~ n r h- fyl filed by the a state reoras rzrn w ayn C. Tha above inforea ion is incorrect end/ar debts and tleduciions warms r~sJ.~ O ~ Cowplete PART 2~ and/or PART ~ below. ~ ~ C7 n ~ PART If indicating a tlifferent tax rater Please state relatSOnshlp to tleeeden t: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Establishetl 1 2. Account Balance 2 S5 3. Percent Taxable 3 X 4. Amount Subd eet to Tax 4 $ 5. Debts antl Deductions 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Duo 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter en Line 5 of Tax Computation] 8 Undo penalties of pe?rjury. I declare that the facts I reported above are true, correct antl com ete~ tip bash my knowletlge and belief. 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