HomeMy WebLinkAbout07-21-05
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
'*'
INFORMATION NOTICE
! ,ECO'fAOOVEit~ESPONSE
REV-1545 EX AFP (09-00>
FILE NO. 21 05-0211
ACN 05132434
DATE 07-13-2005
2nns Hi' ')1 ~" If.. .1
!il.'j ,,\..... ::.. iE;-i:'.; ~~:t'1.0YD C GATES
S.S. NO. 185-03-1249
!TJ)4'fE OF DEATH 02-04-2005
,con~1~ CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
IX] CHECKING
D TRUST
D CERTIF.
C:t"
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
RONALD L GATES
2409 RYE CIR
MECHANICSBURG PA 17055
COMMUNITY BANKS has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PennsYlvania. Questions may be answered by calling (717) 187-6327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 4800490309 Date 08-19-2002
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
55,737.09
50.000
27,868.55
.045
1,254.08
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a 57. discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
PART
[!]
above information and tax due is correct.
You may choose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
lINE 1. Date Est~bli~hBd
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
I
2
3
4
5
6
7
8
x
If you indicate a different tax rate, please state your
relationship to decedent:
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
facts I have reported above are true, correct and
HOME (7))) "76&' ff"/?7
WORK () > ~ zo--ci..r'
TELEPHONE NUMBER DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005601
GATES RONALD L
2409 RYE CIR
MECHANICSBURG, PA 00017
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
__nun fold
05132434
$1,254.08
ESTATE INFORMATION: SSN: 185-03-1249
FILE NUMBER: 2105-0211
DECEDENT NAME: GA TES LLOYD C
DATE OF PAYMENT: 07/21/2005
POSTMARK DATE: 07/20/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/04/2005
TOTAL AMOUNT PAID:
$1,254.08
REMARKS:
CHECK#1501
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS