HomeMy WebLinkAbout01-03-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21-o7-00()~
06161730
12-15-2006
REY-1545 EX iFP lU9-001
TERESA FITZWATER
C/O 733 OLD SLVR SPG RD
MECHANICSBURG PA 17055
REMIT PAYMENT AND
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
[Xl TRUST
o CERTIF.
FORMS TO:
EST. OF PHILLIP P MADDEN
5.5. NO. 164-30-2957
DATE OF DEATH 11-02-2006
COUNTY CUMBERLAND
HOUSE
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FULTON BANK has provided the Departllent with the inforllation listed below which ha~.t?n~d inc.,,) , 'J, c-)
calculating the potential taK due. Their records indicate that at the death of the above decedent, you were a j~~. r/ben~CiarY'o.f.. '..2J
this account. If you feel this inforllation is incorrect, please obtain written correction frail the financial instit.'u~ att a copy..:
to this forll and return it to the above address. This account is taKable in accordance with the Inheritanca TaK Law~o the ~onw~~~,
of Pennsylvania. Questions lOay be answered by calling (717) 787-8327. I , N r- c>
COMPLETE PART 1 BELOW... SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION~ 0J~1
-.l
Account No. 1818-38424 Date 05-29-1984 To insure proper credit to your account, two
Established (2) copies of this notice IIUSt accollpany your
paYllent to the Register of Wills. Make check
payable to: "Register of Wills, Agent...
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
10.201.15
33.333
3.400.35
.15
510.05
TAXPAYER RESPONSE
NOTE: If taK payments are made within three
(3) months of the decedent's date of death,
you ..ay deduct a 5% discount of the tax due.
Any inheritance tax due will becolle delinquent
nine (9) lIonths after the date of death.
Tax
x
PART
[!]
A. 0 The above inforntion and taK due is correct.
1. You .ay 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 bOK "A" and return this notice to the Register of
Wills and an official assessllent will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. 0 The above asset has been or will be reported and taK paid with the Pennsylvania Inheritance TaK return
to ba filed by the decedent.s representative.
C.~The above inforllation is incorrect and/or debts and deductions were paid by you.
~You IIUSt co~lete PART ~ and/or PART ~ below.
PART If you indicate a differen~ rat~Please state your
~ relationship to decedent: -51L-r
TAX RETURN - COMPUTATION OF TAX ON J INT/TRUST ACCOUNTS
LINE 1. Date Established 1 0 01 'I. rI
2. Account Balance 2 /Oif),O I, I
3. Percent Taxable 3 X 33 ~ 5B-3
4. Amount Subject to Tax 4 0 </-D 0 I ~ 6
5. Debts and Deductions 5 ~
6. Amount Taxable 6 34tlV ~-35
7. Tax Rate 7 X , 0 '1-$
8. Tax Due 8 153,Oc;t
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I
complete to the best of my ,knowledge and belief.
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