HomeMy WebLinkAbout07-22-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 71 2 8-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX~11-96)
NO. CD 011518
DUPLICATE
MATTHEWS DAKOTA
889 GRAHAMS WOODS ROAD
NEWVILLE, PA 17241
fold
ESTATE INFORMATION: ssN: iso-52-5850
FILE NUMBER: 2109-0680
DECEDENT NAME: RICKABAUGH KIMBERLY
DATE OF PAYMENT: 07/22/2009
POSTMARK DATE: 07/21 /2009
CouNTY: CUMBERLAND
DATE OF DEATH: 05/02/2009
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09129181 ~ 56.63
TOTAL AMOUNT PAID:
56.63
CHECK#543
INITIALS: JN
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
MATTHEWS LACEE
889 GRAHMS WOODS ROAD
NEWVILLE, PA 17241
fold
ESTATE INFORMATION: ssN: ~ 60-52-5850
FILE NUMBER: 2109-0680
DECEDENT NAME: RICKABAUGH KIMBERLY
DATE OF PAYMENT: 07/22/2009
POSTMARK DATE: 07/21 /2009
couNTY: CUMBERLAND
DATE OF DEATH: 05/02/2009
REMARKS:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DUPLICATE
ACN
ASSESSMENT
CONTROL
NUMBER
REV-1162 EX(11-96)
N0. CD 01 1517
AMOUNT
09129180 ~ S 16.09
TOTAL AMOUNT PAID:
S 16.09
CHECK# 542
INITIALS: JN
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAxes - AND FILE N0. 21 ~~ UZfJgO
Po Box zag6ol ~" TAXPAYER RESPONSE ACN 09129181
HARRISBURG PA 17128-0601 :.
' '' '~ ' . - .. DATE 05-13-2009
m:v-isah ~rilre,~wcoe-o4~
ZD~9 JllL 22 ~~ «~ 4Z
CLERK C~
QRPHAPI`S~ OURT
CUN1B""~-R~,gfil~-~ ~ . PA
DAKOTA MATTHEWS
889 GRAHAMS WOODS ROAD
NEWVILLE PA 17241
EST. OF KIMBERLY RICKABAUGH
SSN 160-52-5850
DATE OF DEATH 05-02-2009
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 joint owner/beneficiary of this account
If you feel the information is incorrect, please obtain written correction iron 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 (7171 7b7-BS27 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 233020-0 0 Date 07-21-2003 To ensure prover credit to the account, two
Established copies of this notice must accompany
Account Balance 310.00 payment to the Register of Wills. Make check
$ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
$ 1 5 5. 0 0 NOTE: If tax payments are made within three
Amount Subject to Tax months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
6.9 8 Any Inheritance Tax due will become delinquent
Potential Tax Due $ nine months after the date of death.
P~T TAXPAYER RESPONSE
~ FAILU~ TO RESPOND 4~~LL RESULT IN AN OFFICIAL TAX A55ESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK 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.
ONE
BLOC K ~
0 N L Y
g. ~ The above asset has been
to be filed by the estate
or will be reported and tax paid with the Pennsylvania Inheritance Tax return
representative.
C. ~ The above informs ion is
Complete PART ~ and/or incorrect and/or debts and deductions were paid.
PART ~ below.
PART If 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
OF TAX ON JOINT/TRUST ACCOUNTS PAD
1 1
2 $ 2
s X ~
`' $ 4
5 5
6 $ 6
7 X ~
$ '~ 8
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
PART DEBTS AND DEDUCTIONS CLAIMED
^3
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
pl to tt
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'AYER SIGNATURE TELEPHONE NUMBER DATE
IUTAL (Enter on Line 5 of Tax Computation) 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 bein8 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 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 83,000 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 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 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 Cline 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 Cline 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 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 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 8 1/2" x 11" sheet of paper. Proof of
payment may be requested by the PA Department of Revenue.
TAXPAYER ASSISTANCE
I'f YOU. NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS,
PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU OF INDIVIDUAL TAXES, AT
C7I7) 787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING ANUtOR SPEAKING NEEDS
`LY: 1-800-447-320.
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 T
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AN D
PD BDx zeo6ol ~-'TAXPAYER RESPONSE
HARRISBURG PA 17128-0601
(-, - ,.
.~.. ,. L
REV-1543 EX AFP (OB-08)• ;-, _., ..
FILE N0. 21 0-1 ~(p~
ACN 09129180
DATE 05-13-2009
~GuOi "U~. ~L ~t~ ~O' ~T. OF KIMBERLY RICKABAUGH
SSN 160-52-5850
C~E~?K ~,~~ -DATE OF DEATH 05-02-2009
~P}-~^ti~'$ v(a~~~' COUNTY CUMBERLAND
CUM~~R~ ~ ~~ ~~ PA REMIT PAYMENT AND FORMS T0:
LACEE MATTHEWS REGISTER OF WILLS
889 GRAHAMS WOODS 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 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) 7B7-B3"17 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 233022-0 0 Date 07-21-2003 7o ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance 752.39 payment to the Register of Wills. Make check
$ payable to "Register of Wills, Agent".
Percent Taxable X 50.000
3 7 6.2 0 NOTE: If tax payments are made within three
Amount Subject to Tax $ months of the decedent's date of death,
TeX Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 16 • 93 nine months after the date of death.
PaT TAXPAYER RESPONSE
~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, 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 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 void.
Complete PART 2~ and/or PART 3~ below.
PART If indicating a different tax rate, please state OFFICIAL U5E ONLY ~ AAF
relationship to decedent:
PA DEPARTMENT OF REVENUE
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
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 $ 6
7. Tax Rate 7 X ~
8. Tax Due B $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAIn
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the est of my knowledge and belief. HOME C7[? ) ~L(C(_a~, ~ ']-dIC-C~j
_ WORK C )
AXPAYER SIGNATURE TELEPHONE NUMBER DATE
IUTAL ctnter on Lane 5 of Tax Computation) 8
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. Sian 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 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 83,000 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 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 100 = 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 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 (Line 7) as determined below.
*The tax rate imposed on the net value of transfers from a deceased child 21 nears of age ar younger at
death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 0 percent.
The lineal class of heirs includes grandparents, parents, children and other lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others; adopted descendents and their descendants;
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood
or adoption. The Collateral class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
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 8 1/2" x 11" sheet of paper. Proof of
payment may be requested by the PA Department of Revenue.
TAXPAYER ASSISTANCE
TF= YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS,
P~ DEPARTMENT OF REVENUE DISTRICT OFFICE OR THE BUREAU DF INDTVIDUAL TAXES, AT
Iy,7} 7S7-g~2~, SERVICES FOR TAXPAYERS WITH SPECIAL HEARING ANDIDR SPEAKING NEEDS
LY: 1-800-447-3020.
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
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