HomeMy WebLinkAbout08-18-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280681
HARRISBURG, PA 17128-0681
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
REV-1543 EX AFP (09-00)
FILE N0. 21 OS-0646
ACN 08133401
DATE 07-24-2008
** LARRY J TUELL
1325 KINER BLVD
CARLISLE PA 17013
TYPE OF ACCOUNT
EST. OF FRANCES S TUELL ® SAVINGS
S.S. N0. 446-28-0607 ~ CHECKING
DATE OF DEATH o3-07-2008 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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 decedent, you were 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 form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 199793-05 Date 03-02-2008
To insure proper credit to your account, two
Established C2) copies of this notice must accompany your
Account Balance 17,807.34 payment to the Register of Wills. Make check
Percent Taxable payable to: "Register of Wills, Agent"..
x 50.000
Amount Subject to Tax 8,903.67 NOTE: If tax payments are made within three
Tax Rate C3) months of the decedent's date of death,
X . 0 4 5 you may deduct a 5Y. discount of the taX: due.
Potential Tax Due 400.67 Any inheritance tax due will become delinquent
nine (9) months after the date of death
PART TAXPAYER RESPONSE
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CHECK
0 N E ~
B L 0 C K
0 N L Y
A. ^ The
1.
B. ~ The
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above information and tax due is correct.
You may choose to remit payment to the Register of Wills with 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.
above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
be filed by the decedent's representative.
C. ~ The
You above information is incorrect and/or debts and
must complete PART 2~ and/or PART 3^ below. deductions were paid by you.
PART If you indicate a different tax rate, please state your
relationship to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
DATE PAID PAYEE
-w- o
OF TAX ON JDINT/TRUST ACCOUNTS ~-
4 ~> ~1 a 3 .4 7 ~~~`;
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DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
SPc.c_iAt ~~n2vi
~K-UI ~
TOTAL CEnter on Line 5 of Tax Computation) g
AX
Under penalties of perjury, I declare that the facts
ete to the best of my knowledge and belief.
~2~ ~~c.~~,~~
AMOUNT PAID
I have reported above are true, correct and
HOME C '~ / ~ ) ~,~~-3 -~~ G3
WORK C 7/'7 ) -7 Dl' ~4LIrJ~ $-,IS~U~
TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information
submitted by the financial institution.
2. Inheritance tax becomes delinquent nine months after the decedent's date of death.
3. A joint account is taxable even though the decedent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully•
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "T ax Payer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Wills.
2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17126-0601 in the
envelope Provided.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and
according to the instructions below. Sign two copies and submit them with Your check for the amount of tax payable to the Register
of Wills of the county indicated. The PA Department of Revenue will issue an official assessment CForm REV-1548 EX) upon receipt
of the return from the Register of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of dea
NOTE: taxableefullYtasytransfers.12However,Atheretiswancexclusionenotttouexceedo53t000mper transferee(regardless ofatheavalue of
the account or the number of accounts held.
If a double asterisk (^*) appears before Your first name in the address portion of this notice, the 53,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIYINGBJOINT OWNERS X lOD = PERCENT TAXABLE
JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons.
1 DIVIDED BY 3 CJOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7% (TAXABLE FOR EACH SURVIVOR)
B. The Percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one near of death by
the decedent.
1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = 5D% (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax Cline 4) is determined by multiplying the account balance (line 2) by the percent taxable (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4 .
7. Enter the appropriate tax rate Cline 7) as determined below.
Spouse Lineal Sibling Collateral
Date of Death
6% 15% 15%
07/01/94 to 12/31/94 3%
6% 15% 15%
01/01/95 to 06/30/00 0%
4.5%~ 12% 15%
07/01/00 to present 0%
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%.
The lineal class of heirs includes grandparents, Parents, children, and lineal descendents. "Children" includes natural children
natural parentstand theirbdescendents,bwhethersoranotttheyhhaveebeendadoptedhbydothers~,ladoptedsdescendentsnanddtheirldescendantsf the
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficDE$T$ AND DEDUCTIONS CLAIMED
CLAIMED DEDUCTIONS - PART 3 -
Allowable debts and deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal rev resentative is insufficient
to pay the deductible items.
B. You actually Paid the debts after death of the decedent and can furnish proof of pay men .
r noti+~ nn;na claimed must be itemized fully in Part 3__ If additional space is needed, use plain paper 8 1/2" x 11". Proof of
Ronan Funeral Home
2~~ York Road
Carlisle. Pennsylvania 17013
Phone 717-3~8-9863
Tuesday. March 18, ?008
Mr. Larry Tuell
1325 Kiner Blvd
Carlisle, Pa 170 f ~
Lynn A. Ronan. Funeral Director
We Care 100°'0
Our Family Serving Your Family
Fax 7 17-2~4 ! -~40~-4 I
v~ar Larry,
Thank you for selecting our funeral home to provide services for your t~~tmily during }our time of bereavement. I hope that you
found our services. so tar, to be of the highest standards that we ahvays try to achieve. The following is a summary of the
sereice charges as previously explained and provided in written form on the services tor:
FRANCES TUELL
TOTAL OF PROFESSIONAL SERVICES,
FACILITIES AND AUTOMOTIVE EQUIPMENT
Merchandise
Casket: Poplar
Air Tray Shippm Container
SPECIAL SERVICES $3.995.00
$ 250.00
$4,245.00
Forwarding or Receiving Remains
TOTAL SPECIAL CHARGES $ 2,275.00
52,275,00
CASH ADVANCES
Newspaper Notice
Certified Copes of Death Certificate 10
$ 99.90
$ 60.00
Airfare (United A-rlines)
Transportation to Dulles Airport $ 728.50
$ 300.00
$ I , 188.40
TO'T'AL FUNERAL CONTRACT 57,708.40
BALANCE DUE $7,708.40
If there are any questions or concerns that remain unanswered, please call me.
Sincerely
~,/` ~
~~;~%'f:
Lynn A. Ronan
Funeral Director
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4Nuff s'lst Mortuar
9I 1 Biermann Box 236 - 120 N. King Box 555 - 213 W. Wichita
Garden Plain, KS 67050 NH~. Hope, KS 67108 Colwich, KS 67030
(316) 535-2211 (316) 667-2351 (316) 796-0894
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Date of Death: ~~(\~~~ L.Y~ ~ ~~G C` S;
Place of Death: !,~ ~;~,~~,~,~~ _ ~ (-~
Date of Statement: ~ \ \, ,~, r _C ~ <~ ~ ~C' C
(A) Service, Facilities & Transportation
Basic Services of Funeral Director, Staff & Overhead $ ~,' 1 C
Embalming (See Disclosure) ................................
Other Preparation of Body ..................................
Use of Facilities and Staff for Visitation .................. I'~.' l Ll
Use of Facilities and Staff for Chapel Funeral
Ceremony ........................................................
Use and Transfer of Equipment and Staff for Funeral
Ceremony Elsewhere ......................................... ~ . ~'
Use of Facilities and Staff or Transfer of Equipment
and Staff Elsewhere for Evening Service ................
Use of Equipment and Staff for Graveside Service ...
Transfer of Remains to Mortuary ..........................
Casket Coach ................................................... .~."1 `i . -)C>
Family Limousine ..............................................
Casket Bearer's Limousine .................................. ~,~; (, . ('
Flower Van ......................................................
Additional mileage @ $1.25 /mile ................
TOTAL CHARGE $ ACC . C`Cl
(B) Merchandise
Casket (or alternative container) .......................... $ fJ ~ ~~
Name or Number
Material
Color
Outer Burial Container ........................................ / C)CX?. C~C~
Name or Number C~~~,<_~~~,~.~~~~.
Material ~ ~ , L~ .~_ t~ _~ ~;~
Crucifix ............................................................
Shipping Case ..................................................
Cremation Urn ..................................................
Acknowledge Cards .... ~......1': ~ `i :......................... 7. C' C
Service Folders /Prayer Cards .............................
Register Book ................................................... ~~ ~ . C ~
SUBTOTAL $ / (~.3~.. C~
SALES TAX ~ 5 C% ~~
TOTAL MERCHANDISE AND TAX $ ~ O`1 ~- C%~~
(C) Special Sen~iccs
=orwarding of Remains to:
2eceiving of Remains from:
mmediate Burial .............................................
direct Cremation .............................................
3ody Donation for Medical Research ...................
TOTAL OF SPECIAL CHARGES $ _ ~ "~
DISCLOSURES:
4easonforEmbalming _~~,^~~ ~_~t~- ~~C~% ~.-LLrtiC-1 .c
k:Y ~ `
f any legal cemetery or crema _ ry requirements have required the
purchase of any items listed, the law or requirement is explained below.
1 . 42 11. t'~ 2 ~1
~ STATEMENT OF ~
FUNERAL GOODS AND SERVICES SELECTED
Charges are only made for those items that you selected or that are required. If we
are required by law to use any items, we will explain the reasons in writing below.
if you selected a funeral that may require embalming, such as a funeral with viewing,
you may have to pay for the embalming, You do not have to pay for embalming you
did not approve if you selected arrangements such as direct cremation or immediate
`burial. If we charged for embalming, we will explain why in what k~llows.
(D) Cash Advance Items
Certified Copies ~f Death Certificate
-,
First Copy @ F~c,~ ~.~~ i~1-t
Additional Copies @ /copy ......
Clergy ...................................................... ~-, ~t~~.-~.,~
Organist ................................................... 1-~- .,r._4 .~,
Vocalist .................................................... ~ r ~~a~,, .ti ~ ,~
Paid Newspaper Notices .............................. y 1 ~~ , (;~"~
Grave Opening and Closing .......................... '-1 C)C . C C.`
Funeral Escorts .......................................... ~,::~t:~ ~,~,
Trans ortation Commercial
P t ) ........................ ~-)~ ~~.C C
Flowers Tax
Cemetery
Tent and Equipment3CC• C`~C' Tax l~ ~1 ~ 3 1 ~ ,~~~ (`
Other .......................................................
Other .......................................................
Other .......................................................
Transportation Ordered by Co. Coroner ..........
TOTAL CASH ADVANCES $ ~ ~~ ~ x . ` i C
SUMMARY:
~.
(A) Total Service Charges ........................ $ ~G'~, . C C'
(B) Total Merchandise Char es $ 7 L ` i "7. L, , ~,
g ................
(C) Total Special Services ~ %'
(D) Total Cash Advances ........................ $ ~ <~ I `~ ~ ` j C.
GRAND TOTAL $ '>`b I ~J _ `
Less Credits and Prepayment
CASH DOWN PAYMENT ........................... $ ~ C~
BALANCE DUE $ ~ ~ I ~ ` 1 ~~
Charge To:
Name: -~C~:~~~.--1 ~~r~~~.
1
Address: ~ 3 -~.'~ ~ ~ t.+i~~~-'~L- Y , 1.~.-~
City: '. _('L~:-.~.G Stat~9~-.ZiP~ i~
Telephone Number: --I i 7 - 7C i :~~4'-l
ACKNOWLEGMENT AND AGREEMENT
I hereby acknowledge that I have the legal right to arrange the final services for the
deceased, and 1 authorize this funeral establishment to perform services, furnish goods,
and incur outside charges on this Statement. Acknowledge that I have received, on this
date, the General Price Lisi and Outer Burial Container Price List. I also acknowledge
execution and receipt of a copy of this Statement.
Terms of Payment: The Balance Due is payable
After
Minimum Monthly Payments .......................................... $_
a FINANCE CHARGE of % monthly.
(ANNUAL PERCENTAGE RATE of %) will be added to the unpaid
portion of the Balance Due, which is the AMOUNT FINANCED. I agree to pay and 1 or
guarantee payment of the charges listed on this Statement, plus any applicable finance
charges. In the event of default of payment, I agree that the liability is being personally
assumed by taw upon the estate, and This agreement does not constitute a release of
liability. By my signature below, acknowledgment and agreement of the above is
hereby made:
Personal effects other than jewelry wilt be disposed of in 10 da~~s unless called for.
x
Signed
Address
x ~ a
Co-Signed \
ress
X
o- igne
ress
ACCEPTANCE: This funeral establishment agrees to provide all service,
merchandise and cash advances fndfcated on this Statement.
ey:
Date: