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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES '~ ~' ~ ~ ~'':"~ AND FILE
Po BOX 280601 ~ ; ,'! a ='TAXPAYER RESPONSE ACN
HARRISBURG PA 17128-0601 W w ; ~ ~i ,.
DATE
REV-1543 EX AFP COB-08)
N0. 21 ~-~U~ - 90~P
09154757
08-27-2009
~~~~ ~~ "'~ 1~I~ ~ I' 2O TYPE OF
EST. OF MICHAEL SKELTON
~~E~~ ~`?~ SSN 175-48-2957
QRPN~I~'~ ~01~R?~ DATE OF DEATH 0 8- 0 3- 2 0 0 9
~,;~~.~~f_~~!__; ,f`~.1~1 ~;~~'., ~~1, COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
BARRY SKELTON REGISTER OF WILLS
6501 CARMEN COURT CUMBERLAND CO COURT HOUSE
HARRISBURG PA 17112 CARLISLE, PA 17013
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 tFie 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 ret~^n it Lo the abcva address. Thas acccsrt is t:.xable in accordnco with the Inl:eritarce Tax la:a of the Ccmmonr:ealth of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
~~
• ~- • ~~ ~v~ .+~~ amines 7 yr ~ ax l.OmpULaLlOn) $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
comp to the best o ledge and belief. H 0 M E C ) Q 9T
~.~/1 WORK C ) II
TAXPAYER S N URE TELEPHONE NUMBER DAT
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 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 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 C**) appears before your first name in the address portion of this notice, the 83,000 exclusion
was deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account including interest accrued to the date of death.
3. The percentage of the account that is taxable to each survivor is determined as follows:
A. The percentage taxable of joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TO EACH SURVIVOR)
B. The percentage taxable for assets created within one 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)
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 Cline 5) from the amount subject to tax (Line 4).
7. Enter the appropriate tax rate (Line 7) as determined below.
*The tax rate imposed on the net value of transfers from a deceased child 21 Years of age or Younger at
death to or for the use of a natural parent, an 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:
.Date of Heath Sp0l:~: Lineal Sibling Collat9ral
07/01/94 to 12/31/94 3 percent 6 percent 15 percent 15 percent
01/01/95 to 06/30/00 0 percent 6 percent 15 percent 15 percent
07/01/00 to present 0 percent 4.5 percent * 12 percent 15 percent
A. You are legally responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually Paid the debts after the death of the decedent and can furnish 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.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
SKELTON BARRY
6501 CARMEN COURT
HARRISBURG, PA 17112
-------- fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 175-48-2957
FILE NUMBER: 2109-0906
DECEDENT NAME: SKELTON MICHAEL
DATE OF PAYMENT: 01 /05/2010
POSTMARK DATE: 01 /04/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 08/03/2009
REV-1162 EX(11-96)
NO. CD 012191
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09154757 ~ $19.85
TOTAL AMOUNT PAID:
REMARKS: PAMELA SKELTON
CHECK#5568
SEAL
INITIALS: WZ
$19.85
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS