HomeMy WebLinkAbout01-05-07
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 06-0834
ACN 06159517
DATE 12-05-2006
REY-154S EX IFP lD9- DOl
CLERK OF
ORPHAN'S COURT
ClJuPr::~! n .11"'1 ({i Pi\,
tVL... ....: 1._' ',_ _ .,' '. _.,", "
TYPE OF ACCOUNT
EST. OF ELSIE ~ FRANCIS D SAVINGS
S.S. NO. 20~-24-7489 D CHECKING
DATE OF DEATH .09-04-2006 D TRUST
COUNTY CUIi'1BERLAND IX] CERTIF.
~' REMIT PAYMENT AND FORMS TO:
REG STER OF WILLS
CUM ERLAND CO COURT HOUSE
CAR ISLE, PA 17013
2001 JAN -5 PH I: 17
JOSEPH FERNANDES
14 MALLARD CT
MECHANICSBURG PA 17055
MEMBERS 1ST FCU 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 decedenlt, you ware 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 for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of PennsYlvdoia. Questions adY be answered.by caiiing (717) 187-&3Z7.
COMPLETE PART 1 BELOW . .
Account No. 252074-40
I
. SEE REVERSE SIDE FOR FILING ANDiPAYMENT INSTRUCTIONS
Date 10- 05-2004
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
40,302.06
50.000
20,151.03
.15
3,022.65
TAXPAYER RESPONSE
To insur~ proper credit to your account, two
(Z) copies of this notice .ust accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
x
NOTE: If tax payments are l18de within three
(3) IKmths of the decedent's date of death,
you ~y deduct a S7. discount of the tax due.
Any inheritance tax due will b8C~ delinquent
nine (9) IIOl'Iths after the date of death.
Tax
PART
[!]
The above information and tax due is correct.
1. You may choose to remit payment to the Register of Wills wit~ 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.
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
lINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
S
6
7
8
x
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED i
PAYEE
DESCRIPTION
AMOUNT PAID
!
,
TOTAL (Enter on line S of Tax Computation) $
perjury, I declare that the facts I have reported
IIY now ledge and belief. IJ/ll,HOME (
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