HomeMy WebLinkAbout09-28-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
_INFORMATION NOTICE
,~ r.,... ^f~ AND
:-':-",,:(",T~g O~~I;~~j:lAYER RESPONSE
REV-l!i4S~ir:~F~!~~~:' ::~ ..,;
FILE NO. 21 OLD O~57
ACN 06147898
DATE 09-15-2006
TIFFANY LEVINE
198 ROSE HILL DR
NEW CUMBERLAND PA 17070
TYPE OF ACCOUNT
2006 SEP 28 PH 12: ~T. OF ROBERT S LEVINE IX] SAVINGS
S. S. NO. 185-80-6607 D CHECKING
CLERK OF DATE OF DEATH 05-28-2006 D TRUST
ORPHAN'S COURT COUNTY CUMBERLAND D CERTIF.
CUM8E!~LpND CO" PA REHIT PAYttENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE# PA 17013
HEHBERS 1ST FCU has provided the lltIparbnlnt with the infonlation listed below which has b..n 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 infonlation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this fan! l!II1d return it to the above address. This IICCOU.,t is blxable in accordance with the Inheritance Tax L_s of the COIIsonwealth
of "ennsYlvanla. Questlons.y be an_...... l)y callirlii (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 225501-00 DIIt. 01-03-2003
Established
Account Bal.nc.
P.rc....t T.xul.
AIIow.t Subj.ct to
T.x R.t.
Pot....ti.l T.x Du.
x
436.02
16.667
72.67
.045
3.27
TAXPAYER RESPONSE
To Insure proper credit to your account, two
(2) copies of this notlce IIUst accOllpany your
pa~lII"It to the Register of lIills. Milke check
payable to: ftRegister of lIills, Agen~.
x
NOTE: If tax paysants are sade within thr..
(3) ~nths of the decedent's date of death,
you .y deduct a SlC discount of the tax due.
Any inheritance tax due will beco.. delinquent
nine (9) sonths after the date of death.
T.x
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
o The above inforsatlon and tax due is correct.
1. You say choose to res1t pay..nt to the Register of IIllls with two copies of this notice to obtain
a discount or avoid interest, or you .y check box ftAft and return this notice to the Register of
IIllls and an official asses..ent will be Issued by the PA Depart.ent of Revenue.
o 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.
lit! The above infor.tlon is incorrect and/or debts and deductions were paid by you.
You Bust coapleta PART [!] and/or PART @] below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. D.t. Established
2. Account B.lenee
3. P.rc....t T.xul.
4. A.ount Subj.ct to T.x
S. D.bts .nd D.ductions
6. A.ount T.xabl.
7. T.x R.t.
8. T.x Du.
0; T}X/!}J~rST ACCOUNTS
3 X a o/t:;>
4 Q
S ~h&;)O
6 n
7 X
8
u
If you indic.t. . diff.r....t t.x r.t.~s. st.t. your
r.lationship to dec.dent: ~ 0 J\__
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL (Ent.r on Line S of T.x Coeput.tion)
.
V'
p.rjury# I declare that the f.cts I h.v. report.d above .r. trUB# correct and
.y knowledge end beU.f. HOME ( >'::2.;O;J.L)()::z..- k ~
W~~~EP~ONE N~MBE ~~;-I
COMMONWEAL TH OF PEtltSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*. i..T.} .O.,'FF.l.~, ,~~~RMATION NOTICE
re, ,~; 1!1jj,,'" AND
,;'ri ,3 "'."lAXPAYER RESPONSE
. --. .~...: '.- - '- '. .
FILE NO.21 OS ()~5'l
ACN 06147899
DATE 09-15-2006
REY-154S EX AFP lit-III
20D6 SEP 28
TYPE OF ACCOUNT
EST. OF ROBERT S LEVINE [i] SAVINGS
CLERK OF s. S. NO. 185-80-6607 D CHECKING
ORPHAN'S COURT DATE OF DEATH 05-28-2006 D TRUST
CUMBEPLtl':O Co., PACOUNTY CUMBERLAND D CERTIF.
REHIT PAYHENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLEI PA 17013
PHI
SEYMOUR LEVINE
198 ROSE HILL DR
NEW CUMBERLAND
PA 17070
HEMBERS 1ST FCU has proyided the Depart..nt with the infonHItion listed below which has bun uSBd in
calculating the potential tax due. Their records indicate that at the death of the &boye decedent, YOU were a joint owner/o.n.ficiary of
thi. account. If you ful this infor..tion is incorrect, please obtain written correction fro. the financiel institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~.onwealth
of Pennllylvenia. Quast:1ons..y be enswered by callir.iil (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 225501-00 Dat. 01-03-2003
EstabUshed
Account Salance
P.rcent Tmcllbl.
AlIOunt Subject to
Tax Rate
Potential Tax Due
x
436.02
16.667
72.67
.045
3.27
TAXPAYER RESPONSE
To insure proper credit to your lICcooot, two
(2) copies of this notice BUst acc_pany your
paYBBnt to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax pay.ents are .ade within three
(3) BOnths of the decedent"s date of death,
you ..y deduct a SiC discount of the tax due.
Any inheritance tax due will bec088 delinquent
nine (9) .onths aftar the date of deeth.
Tex
D The lIbove asset has been or will be reported end ux peid with the PennsYlvania Inheritence Tax return
to be filed by the decedent.s representative. -
~e above infor.ation is incorrect and/or d&bts and deductions ware paid by you.
~ y~ .ust co.plete PART [!] and/or PART [!] below.
PART If you indicat. a different tax rpel IPJease stat. your
~ relationShip to decedent: 1-rt <' /1tt7,
TAX RETURN - COMPUTATION OF TAX ON, 01 T/TRUST ACCOUNTS
LINE 1. Dat. Estllblished I 0
2. Account Salenee ().2--
3. Percent Tmcllble
4. AIIow1t Subject to Tex
S. Debts Mc:I Deductions
(,. AIIount Taxllble
7. Tax Ret. X
8. Tex Due
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
D The abolle infonHItion and tax due is correct.
1. You .ay choose to rHit paYBBnt to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you .ay check box "A" and return this notice to the Register of
Wills and an official asses.-snt will be issued by the PA DepartBent of Revenue.
DEBTS AND DEDUCTIONS CLAIMED
AMOUNT PAID
TOTAL lEnt.r on Line S of Tex eo.putetionJ
jurYI I decla,.. that the
.Y knowledga end beli.f.
$
facts I hav. reported above ar. tru:J ~rr8Ct and
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