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