HomeMy WebLinkAbout01-20-10PENNSYLVANIA INHERITANCE TAX
z INFORMATION NOTICE
• BUREAU OF INDIVIDUAL TAXES '_•~'"(. ~'`.~ AND FILE
PO BOX 280601
HARRISBURG PA 1~12B-o6o1 - _ TA~G'PidYER RE~;PONSE ACN
,_ ,
REV-1543 EX AFP C08-08) _ +. ' _.. • _. DATE
BRIGITTE
39 WILLOW
ENOLA
ALANDAR
WAY DR
PA 17025
EST. OF HUGUETTE THOMPSON
.,~ -; .`: ;~,,:~ SSN 585 - 32 - 6212
"`"`'~'` ` ~~'~ DATE OF
~~~;~.,~;•,,,,~~~~ ~~~..1R~ DEATH 09-07-2009
,,~ ,~ ~--,_ -; ; eft, ~~ COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
N0. 21 09-0996
09174549
11-27-2009
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SOVEREIGN BANK 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
r~ennsylvenia. Flease call ii17) i8%-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 2561004724 Date 12-19-2002
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 877.86 Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax $ 438.93 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate ~( .045 deduct a 5 percent discount on the tax due.
Potential Tax Due ~- 19.75 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
• ~ .. . ~:
,.f~. r~ i ..G.~yy, O:
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
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 paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please-s-Mate ~~;' •' ,e
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
PART
0
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) #
Unde n 1 ~e~pf perjury,~declar~e.-that the facts I have reported above are true, correct and
co 1 e he bust/~~ w1~'9~ and belief.
HOME C )
WORK ~~~7 ) Z3!-,yY~"- /-iS--/a
TAXPAYER SIGNATURE TELEPHONE NUMBER
DATE
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
3 X
4
5 -
6 +~
7 X
8 $
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with avplicable in:erest 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 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 ar titled in the manner existing at date of dea
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 C**) 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 SURVIVINGBJOINT OWNERS MULTIPLIED BY 100 = PERCENT TAXABLE
JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TO EACH SURVIVOR)
B. The percentage taxable for assets created within one 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 Cline 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.
Date of DQath 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
*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 then 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
ar 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
____ ~_ ___...._+..a ti., +tio pe naoartment of Revenue.
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 09-0996
PO BOX 280601 ,~- -
w-RRISBURG PA 1712a-o6o1 ~ ' ,TAXPAYER RESPONSE ACN 09171143
eev-is4~,',ex_;~e~ coa-oe~` ' f. ~. _ DATE 11 - 04 - 20 09
f ~~ ~ ~ ~~~~~ ~ ~ .~~ ~~ 3 ~
r, .
Q~~~ ~~`~;"~ i.:~~ t.~r
BRIGITTE A ALANDAR
39 WILLOW WAY DR
ENOLA PA 17025
EST. OF HUGUETTE THOMPSON
SSN 585-32-6212
DATE OF DEATH 09-07-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
SOVEREIG N BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form
and return it to the ,above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
Pennsylvania. Please call (717) 787-8327 ki#h questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0354003469 Date 01-22-1974
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance ~ 614.74 payment to the Register of Wills. Make check
Percent Taxable X payable to "Register of Wills, Agent".
50.000
Amount Subject to Tax ~+ 307.37 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 ~ 13. $3 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
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
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. ~he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance
0 N L Y to be filed by the estate representative. Tax return
C. ~ The above informs ion is incorr~ect and/or debts and deductions were paid.
Complete PART 2~ and/or PART I~ I below.
PART If indicating a different tax rate, please~-s-Mate sl%•?`,;,y~~f.~
relationshi ~F~~l~° ~.'. "~;:`` ~', :, .•.. ~~
P t o 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
PART
DATE PAID PAYEE
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 $
3 X
4 '+~
5 '-
6
7 X
8 ~`
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) ~
Under enalties of per ~~e~are t~h~ the facts I have reported above are true, correct and
com a the bes ofi~~~ ~bJ~o7•,..~,~~'..9e~rY9 belief.
~, HOME C )
WORK ( 7 ? -7 ) '~--3 d r si~~-- /- i s- ~ ~
T XPAYER SIG 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 joint 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 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 deaf .
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 SURVIVINGBJOINT OWNERS MULTIPLIED BY 100 = PERCENT TAXABLE
JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TO EACH SURVIVOR)
B. The percentage taxable for assets created within one Year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one 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.
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
*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
.__i_.a ~.. a~... DA Ilnnantmont of Revenue.
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES
Po Box 2BO6o1 - ~ -,_. , .,~;. ,, ,_. AND
• HARRISBURG PA 1712E-o6ol - - ~ • Td~PAYER RESPONSE
j
., ,.,.
REV-1543 EX AFP 108-OHi ._ •, _ ~_..:
FILE N0. 21 09-0996
ACN 09171142
DATE 11-04-2009
i~~~ `~~~~~ ~~ ~~~~ ~~ J~ EST. OF HUGUETTE THOMPSON
r _ SSN 585-32-6212
DATE OF DEATH 09-07-2009
-QF~~!E~~~~i ~ ~~-~~T COUNTY CUMBERLAND
r~.;~:{~'-~ ,-• ~,~ ~=.% ~- ~•, ~~`~ REMIT PAYMENT AND FORMS T0:
RICHARD L AL~QNDAR REGISTER OF WILLS
39 WILLOW WAY DR CUMBERLAND CO COURT HOUSE
ENOLA PA 17025 CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SOVEREIGN B S NK 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. i.t 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. 0921700083 Date 11-06-2000
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 11 , 991.49 payment to the Register of Wills. Make check
Percent Taxable payable to "Register of Wills, Agent".
X 16.667
Amount Subject to Tax $ 1 , 998.62 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 $- 89.94 Any Inheritance Tax due will become delinquent
PART nine months after the date of death.
TAXPAYER RESPONSE
~~~'~?c`
. ~ 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
0 N E ,-{,/ Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K B. III The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY 4CLJ 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 •%~~,;,!,~F, •:~ ,fi •..a`
relationship to decedent: •
~`'
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS r~f''F~ '~.~.~,~
~~ ~ :.
1 ~.~~,.. ;.....,: .
LINE 1 . Date Established 4~~~%~'f 'lf~r~,
2. Account Balance 2 ~~~~,,2,''`r~::~a ~!,F r. ~`.',~~ ,
3. Percent Taxable X ..''~ui '~'~`
3 x ; r`.~ F
r`F ~~r
4. Amount Subject to Tax 4 $ ~ ~? ;.~rf,~%~~,.•'~~~J.,~r~'~'. ,•..rE~ f~
5. Debts and Deductions 5 - '~'~~~~'`''`''~"'"
6. Amount Taxable $ ~j~'y~'~~~~`'•ly ~.,. ,~
7. Tax Rate )( '~ ~'
J ~ ,'
8 . Tax Due 8 $ ~yy~F•.,, ~,~ ~` ; • ~ ;
PART '..~/ts~~ ..:h.!`. !f:i:.... ~, , . .:,f, .f~•. cf .,:•r,F„},~:-.,.` ~
^ DEBTS AND DEDUCTIONS CLAIMED
3
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) ~
Under enalties of ry f d~l~ that the facts I have reported above are true, correct and
co le a to th es my knowledge and belief.
HOME C ~
TAXPAYER SIGNATURE WORK C?~? ~ 236 -/fib s~ ~_/S-_~o
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 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 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 C**) 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 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 near of death by
the decedent.
1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = 50 percent (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (Line 4) is determined by multiplying the account balance (Line 2) by the percent taxable (Line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (Line 6) is determined by subtracting the debts and deductions Cline 5) from the amount subject to tax (Line 4).
7. Enter the appropriate tax rate (Line 7) as determined below.
xThe tax rate imposed on the net value of transfers from a deceased child 21 nears of age or Young 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:
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
er a
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
__.._.,..+ ..~., tie rnnllPCtPf~ by the PA Department of Revenue.
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU C?F INDIVIDUAL TAXES A N D
Po Bo;~ 2BO6o1 -- ~~~ FILE N0. 21 09-0996
"IiARRISBURG PA 1712E-o6o1 -- T'AXP AY E R R E S P O N S E
~ ~, ACN 09171141
Rev-1543 ocin~rz~tne-dam ~,- ~ ~ ~-,- DATE 11- 04 - 2009
~~~~~ ~~~~ ~Q ~i~ ~= ~~
BRIGITTE ALANDER
39 WILLOW WAY DR
EN
Q~i~ ~:.r,. ,. L,, ti L.~t.~ ~ ~ r
OLA PA 17025
EST. OF HUGUETTE THOMPSON
SSN 585-32-6212
DATE OF DEATH 09-07-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SOVEREIGN BSNK
potential tax due. Records indicate that pat the de th of the aboveltnamed decedent,lyou weore~ a hich has been used in calculating the
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 fo
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: rm
787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account N~. 0l217000a3 Date
11 - 0 6 - 20 0 0 To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 11 , 991.49 payment to the Register of Wills. Make check
Percent Taxable X payable to "Register of Wills, Agent".
Amount Subject to Tax 16.667
$ 1, 998. (2 NOTE: If tax payments are made within three
T a x R at e X months of the decedent's date of death,
Potential Tax Due • 045 deduct a 5 percent discount on the tax due.
8 9 . 9 4 Any Inheritance Tax due will become delinquent
PAR T nine months after the date of death.
1~ TAXPAYER RESPONSE
G ~ ~ f
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
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
0 N L Y to be filed by the estate representative. Inheritance Tax return
C• ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART L__I below.
PART If indicating a different tax rate
relationship to decedent: ~ Please state ;,r~~;~~;.~:;;~~ n,,~.;..5
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
PART
OF TAX ON JOINT/TRUST ACCOUNTS
1
2 +~`
s X
4 $`
5 -
6
7 X
8 +~`
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
CEnter on Line 5 of Tax Computation)
st 9~,~/IOf1'dw]~nd belief.
.,4.~ ~-eporteG above are true, correct and
HOME C ~
WORK ~ 7/? ~ 23~ -iysr
TELEPHONE NUMBER !~ ~ ~- I ~
DATE
DATE PAID PAYEE
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 near prior to
death are fully taxable.
5. Accounts established Jointly„bntt~usthforananotherlor othershareofullvataxable.to death are not taxab e.
6. Accounts held by a decedent
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in sectioniceSign tworcopiesdanddsubmitsthem withbalcheckafordthe amount of„
in Block A of Part 1 of the "Taxpayer Response
tax to the register of wills of the county indicated. The PA Department of Revenue will issue an official assessmen
(Form REV-1548 EX) upon receipt of the return from the register of wills.
2. BLOCK B - If the asset specified on this native,hPlaceeano"X"lin B1ockPBrofdPart 1 ofpthe w1tTaxPaY r Response° sectionanc5ign one
Tax Return filed by the estate's represent
copy and return to the register of wills of the county indicated.
3. BLOCK C - If the notice information is incorrect and/oandesubmitnthemewithnvoura check forcthelamountaof taxPPayablerto thenregister
according to the instructions below. Sign two copies
of wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receip
of the return from the register of wills. -
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date Cedentcwhotdied9afterl2/12/82 a accounts the decedenthPUtain Jo nt names within one near of death are
NOTE: For a de
fully taxable. Hawevebertofraccountseheldsion not to exceed 53,000 per transferee, regardless of the value o
the account or the num
If a double asterisk (**) apPebalanceoas reported by nthe financial dinstitution n of this notice, the 53,000 exclusion
was deducted from the account
2. Eneere~centagelofathecaccountethatoisttaxablelto eachrsurvivoruis determinedeasffollows:
3. Th p
A. The percentage taxable of Joint assets established more than one Year prioMULTIPLIED BY 100,s dePERCENT TAXABLE
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY SURVIVINGBJOINT OWNERS
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 per~eaccountsB owned bvCtheUdecedent but held
B. The percentage taxable for assets created within one Year of the decedent's death o
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 SURVIVO
4. The amount sub]ect to tax Cline 4) is deonsmlistedyinuPartl3ing the account balance (Line 2)rom the amounttsubJectetoLtax Cline 4).
5. Enter the total of the debts and deducts
6. The amount taxable (Line 6) is determined by subtracting the debts and deductions (Line 5)
7. Enter the appropriate tax rate (Line 7) as determined below.
Lineal Sibling Collateral
Date of Death Spouse
6 percent 15 percent 15 percent
07/01/94 to 12/31/94 3 percent
6 percent 15 percent 15 percent
01/01/95 to 06/30/00 0 percent
* 12 percent 15 percent
07/01/00 to present 0 percent 4.5 percent
*The tax rate imposedSeno ha naturaluParentraanf adoptive paaentaordacstepParentaof theachild isu09percent.
death to or for the u
The lineal class of heirs includes grandparents, adopted~childrennanddstepechildren.deLinealndescendentsenincludeseallachildrenlofrthe
whether or not they have been adopted by others,
natural parents and their descendents, wheeaeasoindividualshwho have atoleastbonetparentainpcommonswithethe decedents whetherabYSblood
and step-descendants. "Siblings are defin
or adoption. The Collateral class of heirs includes all other beneficiaDE$TS AND DEDUCTIONS CLAIMED
CLAIMED DEDUCTIONS - PART 3 -
Allowable debts and deductions are determined as follows:
A. You are legally responsible for payment, or the estate subJect to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually Paid the debts after the death of the decedent and can furnish proof of paymen .
_ .. ._~_ ~__..,. ,.>>;MO~ must be itemized fully in Part 3. If additional space is needed, use 8 1/2" x 11" sheet of paper. Proof of