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HomeMy WebLinkAbout10-02-06 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BO)( Z80601 HARRISBURG PA 171Z8-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE ACN DATE FILE NO. 21 '0'.- d (1.,7 06500457 09-15-2006 REV-1545A AFP (7-08> MICHELE JONES 3610 ALBERTA AVE MECHANICSBURG PA 17050 TYPE OF ACCOUNT EST. OF LOUISE JOHNSTON D SECURIT1 S.S. NO. 180-28-5741 lXlSEC ACC~ DATE OF DEATH 07-03-2006 D STOCK COUNTY CUMBERLAND 0 BONDS REMIT PAYMENT ANa;~ORMS TO: REGISTER QP WILLS ~~ CUMBERLAND:';~ COURbHOUSf CARLISLE,,-P~_:~2 [~701~ '. ,--- '.. I ---:J f" ....::, ., ':~_~ -0 .....:",.)-,"1 ~ AMERICAN FUNDS has provided the Depart.ent with the info~ation listed below which:~ been u~d. in ' calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU wer"-,~ :1i4neficiar'y ":'of this~a!!ise,t. If you feel this infor_tion is incorrect, please obtain written correction fr~ the transfer agent, attach;; COPy to ~for. and -c-i i return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the(Co..onwealthrqj Pennsylvania. QuestIons _y be answered by callIng (717J 187-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73995315 DOD Valuation Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 22,,375.21 33.333 71458.33 .045 335.62 TAXPAYER RESPONSE To insure proper credit to your account, two (l) copies of this notice .ust acc~pany your pa~ent to the Register of Wills. Make check payable to: "Register of Wills~ Agent". x NOTE: If tax pay.ents are made within three (3) months of the decedent.s date of death, you HY deduct a 5Z discount of the talC due. Any inheritance tax due will become delinquent nine (9) months aftar the date of death. Tax PART rn The above infor..tion and talC due is correct. . You may choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, Dr you may check box "A" and return this notice to the Register of Wills and an official asses~ent will be issued by the PA Departaent of Revenue. B. DThe above asset has been Dr will be reported end tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. 0 The above infor_tion is incorrect and/or debts and deductions were paid by you. You aust coaplete PART ~ and/or PART ~ below. [CHECK ] ONE BLOCK ONLY PART [!] TAX RETURN - COMPUTATION LINE 1. DOD Valuation 2. Percent Taxable 3. Allount Subject to Tax 4. Debts and Deductions 5. Allount Taxable 6. Tax Rate 7. Tax Due OF TAX ON ABOVE ASSETCS) 1 2 X 3 4 5 6 X 7 If you indicate a different tax ratel please state your relationship to decedent: PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) perjurYI I declare that the facts I IIY knowledge and belief. I $ and 'J. ... 1 .y..j .....i l'. 1/1 1""l ,~ :r a.. Ct,. ,.,~ ~ . et: ':3 .'J 'a) r'J V'J Ct,. ;-.; tU ~ IJ) .:! ,j'l ,( ('J 1: ~ d~ ~ ~~~' · --}C0~ 1 . '- ... ~ .2. R~(fiRr)FD C~FlCE OF ''''!)r rd"" - 2 Pt1 2: 32 !.Ul~u t~'i.) { - l":'T .,:i! f)\ f';l \....J., ~ :-l' Nl ~~O ~ Q \ 30- ,:oj cf o ~ ~ 33 'j g2 - .. .. - - - - ... - .. .. - - - - .,.., .... CJ t.t (') tn () .,.. .f- l') .,.., o !.... .,.. ,