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Home My WebLink About81-00535 . :'.; ,:z: H ~ ~ 1I.l ~' W PI ~ . li! Q 0 li': l%l 1I.l U . H , ,'1!5 := ~ 1I.l IJ) 1I.l U li': !l! .J. - o 61 ~ JJ UI It-lSTRUCTIOt-lS TYPE OF ASSET _ Indicate whether the assot is real estate, personal property, transfer or jointly-owned. DESCRIPTIOt-l _ List all a..et> awned solely by the docedent or awned iaintly with another party or partie, as tenants in common or os joint tenants with right of survivorship at the timo of death. Include the decedent's percentago of ownership, the name (s) and relationship to the decedent of the surviving ioi,nt owners and the estimated markot value of the decodent's interest 05 of the date of death. Includo intangible personal property titled in the nnme of the decedent but payable 01 death to another party or porties Including but not limited to P.O.D. U.S. Savings Bonds and tentative trust accounts. List any property transferred by the docodent within two years of death for which he/she did not receive valuable and adequate consideration. Describe all real cstate located in Pennsylvania by lot and block number, street address, number of acres and include a general description of the land and building', Also, include the book and page number in which the deed is recorded and the exact title as indicated on the deed. DEBTS & DEDUCTIOt-lS _ Unsati,fied liabilities incurred by the decedent prior to his/her death arc deductible against his/her taxable estate. In addition to debts incurred by the decedent, other items ore claimable including the cost of administration, attorney feos, fiduciary fees, funeral and burial cj(penses including the cost of a buriollot, tombstonc or grave marker. List the date on which each debt was incurred and/or paid and the names of each payee. Pravide 0 brief explanation of the nature of each debt claimed and the amount being claimed, Evidence to support the decedent's or the Ctstate's liability for the debts being claimed should be attached to this return A family exemption may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/her rights, then any child of the decedent who is a member of the same household can claim thc excmption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. -< ~ m r- -; m ~ "ll :l: 0 Z m z ? " -; ,. -; ,~ ~ ~ ,. Z 0 ~ :;: 0 c '" m , m v> ~ v> 0 - , . '< . ;; '" ;; " . ~ ~. -; . , m '" m :r = . . " 0 ~ , !!-: n c -; ~ r- "ll 0 n ,. m ,. ~ Z ,. 0 0 0 '" 0 m Cl n c: 0 -l ~ r- m " z :0 ,. Z Z r- z Z m -< m -l ? :!: ? ? -< -< '" m '" ? '" 0 -l Z 0 :0 ? ." ." ,. -l 0 Z -<-< m m ,. ,. :0 :0 It-lFORMATIOt-l PLACE FOR FILIt-lG _ The retum is to be filed in duplicate with the Regi,ter of Wills of the county wherein the decedent resided. TIME FOR FILING _ Thr. return Is due nine months after the decedent's death, unlcn on exteniiol1 for filing has. been applied for and granted by the Secretary of Revenue within the nine.month period. FAILURE TO FILE RETURt-l _ Section 791 of the 1961 Statute provide, that" . . .any person who willfully fails to file a roturn or other report required of him ihall be personally liable. " .to 0 penalty of 2500 of the tax ultimately found to be duCl or $1,000 whichever is the less to be recovered by the Deportment of Revenue ai debts of like amount are recoverable by tow." NOTE; Fees paid to an e,tate representative; namely, an executor or administrator, for .ervite. performed In ad. ministering on estate is reportable for Pennsylvania Income Tax purposes. Thi. taxable income item shoud be reported on form PA.40.lndivlduallncome Tax Return. INFORMATION To insuro proper credit to your account, tho oamo of tile llstalc and file numbor should bu clllarly prinl- ed on the check or money ordur, This assessment is mado in accordanco with Soction 708 of the Inheritance and ESlilte T~x Act of 1961 (1~ P,S, ~ 2485.7081. To the 01<1e01 that inheritance tax is paid within Ihroo (3) months after the death of tho deCl'dlJn1. a di~count of five (5) porcent is allowed (72 P.S. ~ 2485- 716). Inheritance Ta)(, other than tax on a future interest. is duo Bllhe dale of the decedent's death and becomes delinquent at the expirotirm cf nine (9) months after the decedent's denth (72 P.S. 9 2485.7111. Inheritanco Tax on II future interest is payable within threo (3) months after the transfer takes effect in possession and enjoyment and is delinquent therealter (72 P.S, ~ 2485.712). CalculalO interest from the delinquent daw shown on the face of this form to the date of actual payment using the following interest Hlble: -------------------------------. -- - ---- ------- -- - - --- - --- -- ._---- -- -- - - - ---- 1 month ,005 4 monthS ,020 7 months ,035 10 months ,050 2 months .010 5 months 025 8 months 040 11 months .055 3 months ,015 6 months ,030 9 months 045 12 months ,D60 I days ,00017 11 days ,oot86 21 days .00352 2 days ,00034 t2 days ,00203 22 days ,00369 3 days .00051 13 days ,00220 23 days .00388 4 days .0006B t4 days ,00237 24 days ,00403 5 days ,OOOB5 15 days ,00250 25 days ,00420 6 days .00101 I e days ,00267 26 days ,00437 7 days ,00118 17 days ,OO2B4 27 days ,00454 8 days .00135 18 days ,00301 28 days .00471 9 days .oot52 19 days .0031B 29 days ,00488 10 days ,00169 20 days ,00335 30 days .00500 .. - ------------------- --- - - - - -- -. - - --- - - - -- -- - --- -- -- - - - - --------... ------ Any pany in interest, including the Commonwealth and the personal representati...e, not satisfied wIth the assessment may object thereto within sixty (GO) days after receipt of thIs Notice as provided by Section tOOl 01 thelnherilance and Es,a,. Ta, Act 011961172 PS 82485.10011 Make check or money order payable 10: "Register of Wills, Agent" Mail to the address listed below: