HomeMy WebLinkAbout10-07-13 (4) Po� s06BUI�iow� TrucES Pennsylvania lnheritance Tax � �n���V��»
t�I eUNG PA Yn28-o697 information Notiae �EPAR7MENTOFRFYENUE
PEV-IR9Y�EY DOeE%EC fl!-li>
And Taxpayer Response F��E No.2��3-0550
ACN 13503912
DATE 09-18-20i3
iType of Account
Estete of NANCY M BAftRY Security
SSN �; SEG AccY
Dake of Death 05-03-2013 `,_:
B YAN K YANCURA Counry CUMBERIAND � `-'' s
2 1 PLUM CREEK LN � � � o
D TPPI�NG SPRIN6S TX 78620-4b13 Oa z,y � Ui �
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�the depa+#merrt wittr the iniormatian below irtdicating ttrat at t#te death of the
abcrv �named decedent ou were a'aint awner or beneficia oI the account identified.
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Remft Paymsnt and Forms to:
D1� REQISTER OF WI4LS
Ac+� t Balance $43,�38.85 1 COURTtfOUSE$4UARE
Percrn Taxable X 25 CAqLI3LE PA 17'013
Amaun Subject to Tax $10,97721
T� e X 0.045 NOTE`: ff tex paymeMs are mede within thre�months af the
Potenti i Tax pue $493.97 decedenYs date of death,�duct a 5 perceM diacount on the ttix
Widt 5 Discourrt{Tax x d.95} ${��7�*) due. Any inheritance ta��due will become delinqueM nine morrths
etter the date of death.
PART .StE}(� 1: PIiDdl�ChBCk th@ A�N'O�fBt@ I�OXBS bB�OW.
1
A � tax is due. i am the spause ot the deceased or I am the parent of a decedent who was
21 years atd or y�nger st date of death.
Proceed to SYep 2 on revarse. Do not dreck any other boxes and dlsrogem'tha smount
I shown above as PoteMiat Tar tkle.
' g The infurmatiort is The ahove informatio�is correct,no deduCEians are baing taken,and payment wiii tae sent
� orrect. with my response:
Proceed to Step 2 on reverse. Do rrot chack eny other boxes.
� � e tau rate is incorrect. � 4.5% {am a lineal beneficiary(parent,child,grandchfld etc.}of the deceased.
elect carrect tau rate at
ght,and complete Part � ���, �am a sibling of the deceased.
ai revsrse.}
� 15% AI4 other relatianships{induding rwne}.
p anges w deduc#ans The iMormstion above is incorrect and/or debts and tteductions were paid.
li ted. Campleta Part 2 end part 3 as appropriate on the beck of this/oma.
E wili be r�orted on The abave-identified asset has 6een or wili be repo�ted and tan paid with the PA tnheritance Tax
i heritance tax forrn Retum filed by khe estate representative.
EV-t 500. Praceed ta Step 2 arr reversa. Da nrN aheck any ollrer droxes.
Please sign and date the back of the form when finished. ��
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