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PENNSYLVANIA INHERITANCE TAX
PNC BANK NA vrovided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decadent, you were a joint owner/beneficiary of this account.
If you feel the 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. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
INFORMATION NOTICE ~i (v35
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 ~ t~D
Po Box zao6B1 TAXPAYER RESPONSE ACN 08148643
HARRISBURG PA 17128-0681
REV-1543 IX AFP coe-oe~ DATE 10 - 13 - 20 08
TYPE OF ACCOUNT
EST. OF LUCILLE I LOGUE ^ savlNGs
SSN 180-03-5277 ® CHECKING
DATE OF DEATH 08-26-2008 ^ rausr
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
JAMES N LOGUE REGISTER OF WILLS
62 LITTLE RUN RD CUMBERLAND CO COURT HOUSE
CAMP HILL PA 17011-2045 CARLISLE, PA 17013
Account No. 000009148013183 Date 12- 11 - 1980
To ensure proper credit to the account, two
Established copies of this notice must accompaw
Account Balance $ 2, 173.03 payment to the Register of Wilts. Make check
"
payable to
Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax 1 , 086.52 NOTE: If tax payments era made within three
months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Potential Tax Due
4 8.8 9 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PaT TAXPAYER RESPONSE
r~
• A. The above information and tax due is correct. ~~ ~ ~ ~-G;•'
Remit
payment to the Register of Wills with two copies of
this notice to ob~ C7 C`") ,'
._.~
CHECK a discount or avoid interest, or check box "A" and return this notice to t~s•- er of~
Wills and an official assessment will be issued by the PA Department of Re~: 'IJ ~ ~
C 0 N E ~ Q~
BLOCK B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Dance ~ic return '~
'
0 N L Y to be file d by the estate representative. •
,' rl
C~ ~ ~
C. ^ The above informs ion is incorrect and/or debts and deductions
Complete PART ~2 and/or PART 3^ below. were paid. D ~ ~
~
PART If indicating a different tax rate, please state
relationship to decedent: __
TAX RETURN - COMPUTATION
LINE i. 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
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4 +fi
5 -
6
7 X
8 +~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMni~Nr 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 )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
~~..~ .cn~er on a ne ~ or tax computation) $
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with apvlicable 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 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 joint 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 them 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
(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 estate's representative, place an "X" in Block B of Part 1 of the "Taxpayer 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 Block 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 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 death.
NOTE: For a decedent who died after 12/12/62, accounts the decedent put in joint names within one year of death are
fully taxable. However, there is an exclusion net to exceed 53,000 per transferee, regardless of the value of
the account or the number of accounts held.
If a double asterisk C^^) appears before your first name in the address portion of this notice, the 83,000 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 percentage of the account that is taxable to each survivor is determined as follows:
A. The percentage taxable of joint assets established more than one 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 lOD =PERCENT TAXABLE
DWNERS 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 nultiplving 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 (Line 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 adaptive parent or a stepparent of the child is 0 percent.
Tha lineal class of hairs 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 child ran of the
natural parents and their descendants, 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 varent 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 payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after the death of the decedent and can furnish vroof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use B 1/2" x 11" sheet of paper. Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE ` ---~..,~
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
LOGUE JAMES N
62 LITTLE RUN ROAD
CAMP HILL, PA 1701 1
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 180-03-5277
FILE NUMBER: 2108-1035
DECEDENT NAME: LOGUE LUCILLE I
DATE OF PAYMENT: 10/ 1 6/2008
POSTMARK DATE: 10/15/2008
couNTY: CUMBERLAND
DATE OF DEATH: 08/26/2008
REV-1162 EX111-96)
NO. CD 010416
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08148643 ~ 546.45
TOTAL AMOUNT PAID:
REMARKS: JAMES LOGUE
CHECK# 6003
SEAL
INITIALS: WZ
546.45
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS