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Home My WebLink About01-08-09~. ~_ ~.:. ;,, ~~ ~:: ~~J :., .y v. ~.... ... ~-,. r1 ~'-~1 t~r~ i P ~~ .... ~. ;, ZC~9 JA~1-8 Rri II = 37 CLERK OF pRPI-lAt~'S COURT CUMB~ ~~~ ~`~ CO.. PA ~~ ~ ~ ~ ~ ~ ~' ~:, f ~, n i r ~~~ ~~ 0 ~_ C ., ~4 ~~; ::~ ~' ! ..a .k f`' 14= 4:1 tk3 ~`'~ ~Y `. tt; BUREAU OF INDIVIDUAL TAXES PO BOX 280681 HARRISBURG PA 17128-060:1 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND _ .~;.,,;` _` ~ ~'` TAXPAYER RESPONSE 1rv~yj ~ q ~,. REV-1543 EX HYP'{(~Q?.rF)f V~! :~ ..., T FILE N0. 21 Q~ -CjC~1~ ACN 08160894 DATE 12-11-2008 21iQ9 JAN -8 AM i i ~ 37 C~C.! 1~ ORPHAN'S CgURt Ct1MB~R! f~ CO.. PA VIOLA V JACKA 210 COLONIAL- DR SHIPPENSBURG PA 17257 EST. OF CARL G JACKA SSN 293-26-7887 DATE OF DEATH 11-03-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TD: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. CMMNTY STATE BANK OF ORBISONIA provided 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 decedent, 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1408483 Date 07-31-1998 To ensure proper credit to the account, two EStabl ished copies of this notice must accompany Account Balance $ 696.60 payment to the Register of Wills. Make check Percent Taxable payable to "Register of Wills, Agent". X 50.000 Amount Subject to Tax $ 348.30 NOTE: If tax payments are made within three Tax Rate ~( months of the decedent's date of death, 045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 15.67 Any Inheritance Tax due will become delinquent nine months after the date of death. P~r 1 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ICI The above information and tax due is correct. ~{ Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K ~ B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax retu 0 N L Y to be filed by the estate representative. rn C. [] The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART IJ below. PART If indicating a different tax rate, Please state OFFICIAL U5E ONLY relationship to decedent: Q AA F PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pAD LINE 1. Date Established 1 I 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate T X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE nFCrRrprrnu ........._ ____ - -- - -- '- i ax i.o mpULailOnJ $ 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~.3~ ~ y7~~~99~ AXPAYE SIGNATURE v o3 0 TELEPHONE NUMBER A 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 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 "T ax Payer 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 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 (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 deat . NOTE: For a decedent who died after l2/12/82, accounts the decedent put in joint names within one Year of death are fu11Y taxable. However, there is an exclusion not to exceed S3,000 per transferee, regardless of the value of the account or the number of accounts held. wasadeductedafromlthe(accountebalanceoas reportedsby nthe financialdinstitutionn of this notice, the 53,000 exclusion 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 SURVIVINGBJOINT OWNERS MULTIPLIED BY 100 = PERCENT TAXABLE 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 near 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 (Line 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (Line 7. Enter the appropriate tax rate (Line 7) as determined below. Spouse Lineal Sibling Collateral Date of Death 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 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 beneficiaDEBT$ AND DEDUCTIONS CLAIMED CLAIMED DEDUCTIONS - PART 3 - Allowable debts and deductions are determined as follows: 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 Proof of paymen . 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. TAXPAYER ASSISTANCE IF YDU NEED FURTHER INFORMATION DR ASSISTANCE, CDNTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU DF INDIVIDUAL TAXES, AT (717) 787_8327, SERVICES FDR TAXPAYERS WITH SPECIAL HEARING AND/DR SPEAKING NEEDS ONtY: 1-8~~-447-320. COMMONWEALTH OF PENNSYL'/ANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 010743 JACKA VIOLA V 210 COLONIAL DR SHIPPENSBURG, PA 17257 fold ESTATE INFORMATION: ssrv: 2sa-2s-~$a~ FILE NUMBER: 2109-001 6 DECEDENT NAME: JACKA CARL G DATE OF PAYMENT: 01 /08/2009 POSTMARK DATE: 01 /05/2009 couNTY: CUMBERLAND DATE OF DEATH: 1 1 /03/2008 REMARKS: CHECK#559 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 08160894 ~ S 15.67 TOTAL AMOUNT PAID: INITIALS: JN REV-1162 EX(11-96) S 15.67 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS