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HomeMy WebLinkAbout06-04-09N O ci F-- t_~' -- t~ ; ~~~ G/.) . ~ ~ 11J ~" r3- `. . _ x ~ . ~~ ~~_ ~ , C:~ CJ 3 ~~ s 0 C 247.99x+ 12.4 - 235.5 c 461 •61=xt 23.08 - 438.53 ~ C 229.8bx+ 11.49 - 218.37 ~ c 9.3.63x+ 4.68 - 88.95 x C 235.59xt 438.53 t 218.37 t mss .qco~ 8 8.9 5 + 9$1.44 x 'Lhe~k w0.s -etc-r ~lgt.`~5 c e 247.99 x 0.05= 12.4Ux c 4b1•bl x • Q ~..: 23.0£sx C 229.8=b x 0.0~= 11.49x G 9363 x p•05= 4.6;8 x r • BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REY-1543 IX ~~IF~-C08-DBi PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE _ AND FILE N0. 21 ~q ~ jl'"~ _ ' TAXPAYER RESPONSE ACN 09128395 DATE 05-13-2009 ~~`~ Jl.- -3 Phi d~. JZ ~~ ~F?~; ~.;~ ORPnfi"l'~ ~~~.)~..~~~ Gl'h'`" "-``'~_ ~~ ** KATHY DRYE 402 MOHAWK ROAD NEWVILLE PA 17241 EST. OF EDWARD ZELLA SSN 170-18-3493 DATE OF DEATH 04-23-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 ioint 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 Account No. 330701-0 0 Date 05-27-2008 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 5,510.86 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to Tax $ 5,510.86 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X .045 deduct a 5 vercent discount on the tax due. Potential Tax Due $ 247.99 Any Inheritance Tax due will become delinquent nine months after the date of death. P~T 1 TAXPAYER RESPONSE ~.. ND~WILL fULT IN AN OFFICIAL TA ASSESSMENT A. ~~he above information and tax due is correct. y~ Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, ar check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOCK 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 informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state " relationship to decedent: Z ~. PA l7EPARTMENT (1~ TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ PAD ~~ ' LINE 1. Date Established 1 r -~-~ 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 $ G 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AM~l1NT PArn Under penalties of perjury, I declare that the facts I have reported above are true, cor~rg/ct and complete to the est of my knowledge and belief. HOME C~ ~ ~ ) ~~5' ~~ d WORK C?1 ~ ) LIU-(o a-~ TAXPAYER SIGNAT RE TELEPHONE NUMBER DATE IUTAL ctnter on Line 5 of Tax Computation) $ 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 vear 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 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 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 wanner existing at date of death. NOTE: For a decedent who died after 12/12/82, accounts the decedent put in joint names within one year of death are fully taxable. However, there is an exclusion not to exceed 53,000 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 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 vear prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BV 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 (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. *The tax rate imposed on the net value of transfers from a deceased child 21 nears 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 then have been adopted 6y 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: 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 payment. C. Debts being claimed must 6e 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. TAXPAYER ~STANC.E YOU NEED FI~RTHER INFRRHATIQN OR ASSI$'TANGE, CONTACT ANY REGISTER OE WILi.S, DEPARTMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU DF INDIVIDUAL TAXES, AT 17) X87-8327. SERVICES FOR .TAXPAYERS WIT~i SPGCIAL HEARING ANBIDR SPEAKING NEEDS DI'k~Y: ~~-5,00-447-3(20. 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 BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND ,TA~QPAYER RESPONSE REV-1543 EX AFP (08-OB)~ ~ - TAX FILE N0. 21 ~}~ Usi'~ ACN 09128397 DATE 05-13-2009 ,~t~9 J~~ _3 ~~ ~V~ ~T. OF EDWARD ZELLA SSN 170-18 3 ~1..~~` (~;I KATHY DRYE ~R~~~T,+ i° ,~,}1F CL~ 402 MOHAWK ROAD NEWVILLE PA 17241 - 493 DATE OF DEATH 04-23-2009 COUNTY CUMBERLAND ~7~EMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 point 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. 330 701-40 Date 05-27-2008 7o ensure prover credit to the account, two Established copies of this notice must accompany Account Balance $ 10,258.05 payment to the Register of Wills. Make check " payable to Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to Tax $ 10,258.05 NOTE: If tax payments are 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 $ 461 .61 Any Inheritance Tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONSE ~ 1 =~ ~ ~~ ._5 ._. - CHECK ONE BLOCK ] ONLY The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or 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. B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the estate representative. C. ~ The above informs ion is incorr~ect and/or debts and deductions were paid. Complete PART 2~ and/or PART IJ below. PART If indicating a different tax rate, please state ~ relationship to decedent: xDTi= CIAL D 'Y PA DEPARTMENT DF REVLN TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pQD LINE 1. Date Established 1 1 2. Account Balance 2 $ ~ 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ ~ b 7. Tax Rate 7 X °~ 7 8. Tax Due g $ 8 PART DATE DEBTS AND DEDUCTIONS CLAIMED PAID PAYEE DESCRIPTION L1MnI1NT PATT Under penalties of perjury, I declare that the facts I have reported above are t ue correct and complete to a be t of y knowledge and belief. HOME ) ~ ~~ - ~~~ WORK ( ~ ) oZ~ CO ~ ~ Dy ,XPAYER SIGNA E TELEPHONE NUMBER DATE •-..+~ .~.~~o~ u„ jinn o ai lax l.O mPULaLlOn) S 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 "Taxpayer Response" section. Sign one co DY 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 death. NOTE: For a decedent who died afterl2/12/82, accounts the decedent put in joint names within one year of death are fully taxable. However, there is an exclusion not to exceed 53,000 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 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 1D0 = 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 1D0 = 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 4). 7. Enter the appropriate tax rate Cline 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 far 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 61ood 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: 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 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. ~,. TAX~~AYFR ASSIST~1~ YQU NEEA FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF .WILLS, DEPARTMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU OF INDIVIDUAL TAXES, AT 7i7} 787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS 1-8q0~-447-5020. 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 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU DF INDIVIDUAL TAXES AND FILE N0. 21 Ocj ~ ~--1 Po Box zeoeol _ TAXPAYER RESPONSE ACN 09128398 HARRISBURG PA 17128-0601 ' REV-isaa oc ,u•P coe-oe~ - '.: DATE 0 5 -13 - 2 0 0 9 .. .. ~ . '~ TYPE OF ACCOUNT C~r;g ~~i~ _3 ~r`~ ~SS~T. OF EDWARDOZ18L3493 ^ savlNGs CHECKING DATE OF DEATH 04-23-2009 ^ TRUST R~JU('1 F~~K ~ COUNTY CUMBERLAND ~ CERTIF. OI If 1 it C ~ ~~l T CUB"~r ~' ~~,~A~^R~ REMIT PAYMENT AND FORMS T0: KATHY DRYE ' - ! ''r- REGISTER OF WILLS 402 MOHAWK ROAD CUMBERLAND CO COURT HOUSE NEWVILLE PA 17241 CARLISLE, PA 17013 MEMBERS 1ST FCU 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 C717J 7B7-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 330701-41 Date 05-27-2008 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 5, 107.97 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to Tax $ 5, 107.97 NOTE: If tax payments are 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 $ 229.86 Any Inheritance Tax due will become delinquent nine months after the date of death. P~r TAXPAYER RESPONSE 1 AI~LU SFD ILL ULT Iii AI~ DF~ICIAL 7AX ~S~S~ri~NT A. ~he 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 r D N L Y to be filed by the estate representative. eturn C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state •' relationship to decedent: - '~~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pqD LINE 1. Date Established 1 1 - 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 3" 4. Amount Subject to Tax 4 $ 4 ~~`~""" 5. Debts and Deductions 5 - m ~ 6. Amount Taxable 6 $ G 7. Tax Rate 7 X ~ 8. Tax Due g $ B PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRrPTrnu ...,,,...~ ... __ - --- -- -- i an t,a mpuiaLlOn) $ Under penalties of perjury, I declare that the facts I have reported above are ~-u~e~iirregt„ and complete to the est my knowledge and belief. //II l~~`/~G HOME CJ/') ) WORK ( ~ ) ~ ~-- ~ ~? TAXPAYE SIGN URE 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 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 ioint names within one near prior to death are fully taxable. 5. Accounts established Jointly between husband and wife more than one near 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 (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 "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 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 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 12/12/82, accounts the decedent put in ioint names within one year of death are fully taxable. However, there is an exclusion not to exceed 53,000 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 percentage of the account that is taxable to each survivor is determined as follows: A. The percentage taxable of point 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) 4. 5. 6. 7, ^The tax rate imposed an the net value of transfers from a deceased child 21 years of age Y g t 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: A. You are legally responsible for payment, or the estate sub.iect to administration by a personal representative is insufficient to pay the deductible items. B. Yau 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 went may 6e requested by the PA Department of Revenue. -- - - - i_ ~ 3 TAXPAYER AS~AIa1CE ~ ED FURTHER INFORMATION QR A55TS1'ANGE, CONTACT' ANY REGISTER OF W~LS. RENT OF REVENUE IIISTRICT OFFICE OR THE BUREAU DE INDIVIDUAL TAXES,. AT 7_g327. SERVICES FOR TAXPAYERS WITH SPECIAL FfEARING AND/OR SPEAKING NEEDS B. The percentage taxable for assets created within one near 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) The amount subiect to tax Cline 4) is determined by multiplying the account balance Cline 2) by the percent taxable (Line 3). Enter the total of the debts and deductions listed in Part 3. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Line 5) from the amount sub]ect to tax (Line 4). Enter the appropriate tax rate (Line 7) as determined below. 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 or oun er a BUREAU OF INDIVIDUAL TAXES PO BOX 260601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND TAXPAYER RESPONSE REV-1543 IX AFP (OB-08i ~`~ i - " T. FILE N0. 21 C>~t p5l'~ ACN 09128396 DATE 05-13-2009 ~GL,~ `~~~'~ -~ ~1~ ~e: (~1„j SSN. OF EDWAiDOZ18L3493 DATE OF DEATH 04-23-2009 ri ??=!~E1 ,,~ COUNTY CUMBERLAND ~ ~~, i o~-'~n;-' ~~ ~ !~ r~~r REMIT PAYMENT AND FORMS T0: u wlll KATHY DRYE C('~~"";'= "; C}~ REGISTER OF WILLS 402 MOHAWK ROAD -" - CUMBERLAND CO COURT HOUSE NEWVILLE PA 17241 CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 ioint 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 C7I7) 787-8327 with questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 330701-11 Date 05-27-2008 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 2, 080.76 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 100.00 Amount Subject to Tax $ 2, 080.76 NOTE: If tax payments are made within three Tax Rate months of the decedent's date of death, X . 0 4 5 deduct a 5 percent discount on the tax due. Potential Tax Due $ 93.63 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE ~ TO REP W:fLL R~SUL~' IH AN (~F'FICIA~I. TAX A'SS~Sgt~NT A. y~ The / J above information and tax due is correct. y\ Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid i nterest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K D N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inherit T to be filed by the estate representative. ance ax return C. ~ The above inforna ion is incorrect and/or debts and deductions were paid Complete PART ~2 and/or PART 3^ below. . PART Ir indicating a different tax rate, please state 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 1 P PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I have reported above are true, correct and compl to t the est of my knowledge and belief. ~ (~, HOME C" I ) - / S WORK__ C~ ) ~ 4 3a~~ TAXPAYER GNA UR DEBTS AND DEDUCTIONS CLAIMED 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 "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 them with your check for the amouht 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 afterl2/12/82, accounts the decedent put in joint names within one year of death are fully taxable. However, there is an exclusion not to exceed 53,000 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 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 near prior to the decedent's death: L 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 180 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES 4. 5. 6. 7. The tax rate imposed on the net value of transfers from a deceased child 21 year g t 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 owable debts and deductions are determined as follows: You are legally responsible for payment, or the estate subject to administration by a personal representative is insufficient o pay the deductible items. ~u actually Paid the debts after the death of the decedent and can furnish proof of payment. tits 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 •ent may be requested by the PA Department of Revenue. TAXPAYER ASSTST~~CE ED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, TMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU DF INDIVIDUAL TAXES, AT -B327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING ANDlOR SPEAKING NEEDS ~0-447-30~D. Example: Joint account registered in the name of the decedent and two other Dersons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = 50 percent (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (Line 4) is determined by multiplying the account balance (Line 2) by the percent taxable (Line 3). Enter the total of the debts and deductions listed in Part 3. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (Line 4). Enter the appropriate tax rate (Line 7) as determined below. 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 s 15 of a e percent or younger a COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-961 BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 01 1314 DRYEKATHY 402 MOHAWK ROAD NEWVILLE, PA 17241 ACN ASSESSMENT AMOUNT CONTROL NUMBER told ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 2109-0517 ZELLA EDWARD 06/04/2009 06/03/2009 CUMBERLAND 04/23/2009 170-18-3493 TOTAL AMOUNT PAID: REMARKS: CHECK# 326 SEAL INITIALS: JN RECEIVED BY: 5981.45 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS