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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 Q~ ~U51
Po aox zaosol `TAXPAYER RESPONSE ACN 08148619
HARRISBURG PA 17128-0601
'- i DATE 10-13-2008
REV-1543 IX AFP~ll9-B8 Y'- `- ~ -~
EST. OF ARLENE W CARSON
SSN
DATE OF DEATH 02-20-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
~~ca ac ~ ~3 ~~~ -~: 2g
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KIMBER D CARSON
108 EWE RD
MECHANICSBURG PA 17055
SUSQUEHANNA BANK provided the Departwent with the inforwation below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-pawed decedent, you were a point owner/beneficiary of this account
If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, attach a copy to this forty
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
[ B L 0 C K ~ B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid.
Cowplete PART ~2 and/or PART 3~ below.
Account No. 4800046409 Date 06-11-2002 To ensure proper credit to the account, two
Established copies of this notice wust accowpany
Account Balance $ 378.77 paywent to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to
Tax
$ 1 8 9 . 3 9 NOTE: If tax paywents are wade within three
wonths of the decedent's date of death,
TeX Rate X .045 deduct a 5 percent discount on the tax due.
Potential Tax Due
$ 8 , 52 Any Inheritance Tax due will becowe delinquent
nine wonths after the date of death.
P~T
1 TAXPAYER RESPONSE
A. pl The above inforwation and tax due is correct.
ICJ Rewit paywent to the Register of Wills with two copies of this notice to obtain
C HECK
0 N E a discount or avoid interest, or check box "A" and
Wills and an official assesswent will be issued by return this notice to the Register of
the PA Departwent of Revenue.
PART Lf indicating a different tax rater please state
relationship to decedent:
#~~~ ~~
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS '
LINE 1. Date Established 1 ~„'w;
2. Account Balance 2 $
3. Percent Taxable 3 X s'
4. Amount Subject to Tax 4 $ `~
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rate 7 X
9. Tax Due g $
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNr Porn
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. HOME C-1~~T ) 76/-4d~4'
.y / WORK C ( l 7 ~ 4' 33 ` g 3T7 ~U'oZ e~
~J~~/ TAXPAYER S GNATURE TELEPHONE NUMBER DAB TE g
i~, ~/iL lCnLer on Line 5 oT IaX Computation) $
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information
subsitted 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 when the decedent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) the decedent put in faint names within one year prior to
death are fully taxable.
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 fully taxable.
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 "Taxpayer Response" section. Sign two copies and submit then with a 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
CForn 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 estate's representative, place an "X" in Block B of Part 1 of the "Tax paver Response" section. Sign one
copy and return to the register of wills of the county indicated.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check Black C and complete Parts 2 and 3
according to the instructions below. Sign two copies and submit then 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 (Form REY-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 death.
NOTE: For a decedent who died after l2/12/82, accounts the decedent Dut in joint naves within one near of death are
fully taxable. However, there is an exclusion not to exceed fi3,000 per transferee, regardless of the value 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
was 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 Dercentage of the account that is taxable to each survivor is determined as follows:
A. The percentage taxable of joint assets established more than ova year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TO EACH SURVIVOR)
B. The percentage 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 MULTIPLIED BY 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 year of death by
the decedent.
1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = 50 percent (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (Line 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 CLina 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 CLina 7) as determined below.
^The tax rate imposed on the net value of transfers from a deceased child 21 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 percent.
The lineal class of heirs includes grandparents, parents, children and other lineal descendents. "Children" includes natural children
whether or not they have been adopted by others. adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others; adopted descendents and their descendants;
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 beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
Date of Death Spouse Lineal Sibling Collateral
07/01/94 to 12/31/94 3 percent 6 percent 15 percent 15 percent
01/01/95 to 06/30/00 0 percent 6 percent 15 percent 15 percent
07/01/00 to present 0 percent 4.5 percent * 12 percent 15 percent
A. You are legally responsible for vayment, or the estate subject to administration by a personal representative is insufficient
to vay the deductible items.
B. You actually paid the debts after the death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use 8 1/2" x 11" sheet of paper. Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-961
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 010447
CARSON KIMBER D
108 EWE RD
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
fold
ESTATE INFORMATION: SSN:
FILE NUMBER: 2108-1057
DECEDENT NAME: CARSON ARLENE W
DATE OF PAYMENT: 10/23/2008
POSTMARK DATE: 10/22/2008
couNTY: CUMBERLAND
DATE OF DEATH: 02/20/2008
08148619 ~ 58.52
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 346
58.52
INITIALS: JN
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS