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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 06-0779
ACN 06153201
DATE 10-13-2006
REY-15~5 EX AFP 'D9-DDl
EST. OF ALICE L TRIMMER
5.5. NO. 203-10-9175
DATE OF DEATH 08-03-2006
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
D TRUST
IX] CERTIF.
RODNEY E TRIMMER
274 N MIDDLESEX RD
CARLISLE PA 17013
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
C"')
_ <:::>
2.J~~ a 1-_
MErbti"~.lST ~ 5 c.' has provided the Departllent with the inforllStion listed below which has been used in
ca~~log thdCJbtent~<!~x-aue. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
tht[~c~nt. If you f~(this information is incorrect, please obtain written correction from the financial institution, attach a copy
toLJh4.5__.... ~rm a~retu~~~-_~he above address. This account is taxable in accordance with the Inheritance Tax Laws of the COllmonwealth
Of~'~lvani~ QuetI3~~~ be ans~Qred b~ ~allinQ (717) 161-8321.
F~PL~ P~~~BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
2:L '~ccoune.o. 1~::47 Date 06-26-2004
g S Established
C"'...I (.)
Account Balance
Percent Taxable
A.ount Subject to Tax
Tax Rate
Potential Tax Due
x
10,002.76
50.000
5,001.38
.045
225.06
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice IIUSt accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax paYllents are lIade within three
(3) 1I0nths 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.
PART
[!]
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above information and tax due is correct.
1. You may choose to rellit paYllent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you lIay 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.
~ The abo~e asset has been or will be repor!ed an~ta~ patd with the PennsYlvania Inherit~nce Tax return
to be hIed by the decedent.s representatIve. vu-, J;Q ~P-l c(.. AU"'-~ ctC-<.:~.J-
[] (fllJ.>./t;i, - 8J.,~;J^~ D.c b j ., J... ri"-41 ~
The above information is incorrect and/or debts and dedLctionl w~e paId by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount Subject to Tax
5. Debts and Deductions
6. A.ount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6
7 X
8
If you indicate a different tax rate, please state your
relationship to decedent:
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
(Enter on Line 5 of Tax Co~utation)
$
facts I
above are true, correct and
)
)
NUMBER
~J
,.;z i () ft;
DAT