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Home My WebLink About03-09-10~ i ~, '„ ~. T ~ j y ).. ~ wch- ~- ` ooJ~n Z ~'ca ~~~<~ooo c Qr+f..o0 0 ~°-~-~~ ~~ --~ a t~ ~ z8 =~ / ~ 1 - ~ o r ----~ N r O F• ? O O .a N Z ~ M ~ d O ~ ~ 1 ..~ vvv .~ ~' '\ ('n vvv^ a o o O ~ ,1 ~ T- ~ `"S --~-- ,qJ - ---~. o P~ ~ ,~ ~- ~ ~ ` v~ ~ ~ c ` V ~.r i -° ~ v a y .~ lYW\~ V / .r (^ ~ ~ v`y ~ 1~ M . ~ `~ ~ N .~~ .g ~v3 . ~~~ i~ ~~~ •r•! ~3,•• ~ •r•F PENNSYLVANIA INHERITANCE TAX FILE N0. 21 09-0736 ACN 09165682 DATE 02-19-2010 INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES n~ .n +' A N D Po Box zao6ol ; ' ; , '-4 ~~~~T'~`DFF~~-YER RESPONSE HARRISBURG PA 17128-0601 - ^ .{ ~ !'• * , ~, ~'`,t_';_REVISED NOTICE REV-1543 EX AFP COB-Oi)~-- ~ •a ' ~"' `° ~L~~~~ „, ,...-~~ r.~-r Q~P1•~,~,~~ ~t ~.,=.~t~~ ~ 1 ~ ~ -~ ~ a ,i~~' ~ ~ ~~ TYPE OF ACCOUNT SAVINGS CHECKING TRUST X^ CERTIF. EST. OF MARIAN L BRUDOWSKY SSN 179-14-8711 DATE OF DEATH 07-24-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: KIMBERLY D SCHARDT REGISTER OF WILLS 605 S MAIN ST 1 COURTHOUSE SQUARE MARYSVILLE PA 17053 CARLISLE PA 17013 SUSQUEHANNA 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 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 csll C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 403300001654 Date 03-05-2007 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 1 ~ 297 • 69 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 648.85 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 29.20 nine months after the date of death. PART TAXPAYER RESPONSE J 1 :YF .?%f H.l F%%'i f:Ni': F : .,' :r r'V1 rN:%':f%.ii?p'::':r..l::•:~ :i:! ': %re%:.F kS:::gl..f ii • Fiir..A,u;,.,;,:,.,:..,~.~ . 1 a fF: ,F~:F ffi`% . F!f".!/ r f/"fr'::.b~%f ~i~:':r{"~:4',if':F:~f{~/'r:~ :IFr ::.y .lid :r ~,F~::77u :i'1}~~,7.:~f,. f(.'F.'`~.~~~9 '.f' ' r:f'f: r. F; .y~::H'7.f....' .~:k~:. 4 .f F: r. .9r..:: .L F ,~ ~`',`~ ~h1iF%f `~''Y::rv.`''i.; 'c~. ~'~. f:4.~FiFFi: '~7'/rF:S~ .F~.F. '':'~~.rr.~'?f?,.~ •..~r::'"~''~:,`f.`~:. r'.~'~`~~:F A. I ~ The above information and tax due is correct. u 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 CHECK ONE 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 3~ below. y..3i: .:. fyrfx?i. ~.. . f .r ` fG".` f5•. ` F i?ryF.,:.r •r'•:'•::•r•. ,F/': ?' r :+: !fi''~F }.i/,%A:;H(f,% n~`~• f `i'. /i`f' ,'? :,>.' f` r, ~`. f,'` '~r~ PART If indicating a different tax rate, please state .~?~J;r„y'.y£,r ff~` .a : '1 •i :~; '•.~`'`<` d rF Jyf ~r ~~f f `: ~ + • relationship to decedent: fy%~F,:~~'r~F~,~s`~~,;;~ r%,`F~%`+` r~.'~.?+'~F; .~..p `%;' i:;'.: .,'". TAX RETURN COMP TATI N TA T/ R N ;~~~,`~jy~ff~°~"`'~~` f_f•< ,"'~:%:r~• f,~~,'~•~' r~'+. 'rf: - U 0 O F X O N J O I N T UST AC C O U T S "f'~~~~r~~ ~' f~~ "•'~f'f~~"~>~~ ~`"''` • %f~~4~'"'~' ~~'% ~ f :" r%~`~~lr~ ~?:;y: `f:XP%s.F~:,~'ri~. f:` ri~.'.:•~`~ ~~~~f• • ... 6`'' :y;,r`..~i :'''.'y`f` ~4~' . ~ %,w~o LINE 1 . Date E s t a b 1 i s h e d 1~ . fir'.."`'' Z O C1~ fvf~ r%Fr `~y fs,%';~;fF' ''~~:~:'' 'fir h~, :'~~ `~'`' yr~~: ~' rte' f,'cy, , `'" ~ nr. `.f {:. ji' fFL.'%:•f•': k `G`~N t ~ Fy',c:,'.l/' Fiv :i'` '~ h • ~ y` II ~~/j~. :43:in :.,I:. ). f c,':' `"f.`.`;`.'f% ',.`r~'~L ,y/r ffc~ Y ~: i ~ L ~6:e Y'. ~ r.`" .: ~~::~.'"':,f`:`~~r'~~`:~?i~~:`f°!!+ ~!<;~%.,~r~' r`,4:fF`:~..~'"F':f: J'^' :I .5rk~ 'rF~} %%;'~Y,S, T • { .i/ •` ~ f r H.~~ 2. Account Balance 2 . ;~~Fr~;:;: ` F •" •~ '`N'•: '9:5'`%~Yfi,1'`'%if'6~: •. .`f{' :.`•~}f"f:'~:~~'~::~/f.u<1r:o.~t:.f,f~,:s: 'n'' Gr, ,~: 'J"„prf: p `•ff`%.n ,f.~r,4.fr`~!~ s•'?aff~•,:~„ ~ •n ~ ~ car` :a, 3. Percent Taxable 3 X ,'~d C !r~f'%`~;.f :rr~~.;F:~•f,>::,~:::f.a' ~~c~• s~~.fF~f.~`r.Ff<' •:.~¢:~«i~~~:`~s i Y~:j "".~a stir ; r.: a, ,f,.y`,:i%~ r°:a: ,.:.?...y«k':`.a'iF.'::~: if :r'o:. ,$r.. Ga• rf~ .' Yn'!. r ::: f,,.?/;a. f! : r,"S:f.7;:;ff % 'i:f '.'%i `fE~:: 1. .S'~r„%' .r'^ it i': :~f.:f. ::fi.j ~` / ~/Q Q r~ ~yufayi~.;y,.,~:r:,^``~.,;!;.!~;.sl/r,/:•.5'~%i%/~' .f;':;f F': %;,~r ~' ~r1F ` s~`;~' frt' .~'' 4 . Amount Subject t O T a X 4 T ~O Z /J O / '~ 4s~%frT'3~.`~"%' r.'i, ::?`.:.5•:1;f.'!. ~!<„lw.:.':i~ . F: f ,~.:~F.:s a~' 9 '.¢%!:',•f.;Fs;,f;, ~F::%frn:.f%f/.:%:'C:y`':f.:<:%N'f'.;::f:%:?:°;%c'.'';e':/:%,'.::5•:;,•'{;.'y,Y'°fH:;;yY'!t`''iff;bfflFi'•''•'s'i`,'?r:; `Si:G;.r:.{ ::.,'{n.G ~~~f rr : f. , r/f: 5! x of` :9: fFy'Gf f ~' .~ /,~' ~ ' .f t%xrAz; 5 . Debts and Deductions 5 - ?. .:s:.~/;~'<a... ,.f`.`,.F , •,c~::.,,., : ,:,. 'i rig '~y.:'F,~ ,;~.,°`%.,~~: .:, ~~%~~",:fr,':i r rYBiF:r ;if~i.:`t'l!i :~~ ,G<• yfy::fi,!„G~Yf:~' .:e,~ :;~,'9:i ~ %:e% .ur` ~~ i . ~f%f'F :~~%~6. hl. F~:i/ Ii`''?~,,~~ •r4 ' ...'w,.4' 4,:1 rf 'F Yk°' 9• :" ~/,. f•F • L;r:?~::~•i,:r., p ,/,. ;1,.'% ~ ~/! fi is ~F%~6•fp,A, { ~,~ H.:f'. F•`{. F,y~ ~rF,,:~ y~ / ~) Q ~4r';''r:"r,.`.:'.?:rr ~I~rH''1":?l.•~ '1% •~/~~,~• I f+/''~. `:?9f:.%`'.?:":%F,~';,f:F•'/fi'•• ~`'.r;.i~~'?`~J`fF,l.`•',`;~rfkGF 6 . Amount T a x a b 1 e 6 T LO "I l.~ • ~ `fii< rr::;.h;~•'~f;u.:;y ;' /~~ly~?/v:~, f:`s;:rFwf.:'„'/r.'?~~rr r ! FFy:2::,;~'r.:~`''~~ k ?:~S ,a{ ~~ ,%. ;.?,r`.'~1:%~~~%%:'..': k:ff,~:r:F.s:af/5fd~ ~::ik. `"~fti'"`sib.? ri:f%di :fn'~%+',~>~':%:iSf:•':~fr:.7'~,rF~;•r,tf;,., yr~y s h r: i::,FC,/, l`~ ii fi' ~f.. ~'' 3 ,S y`! Yfr.,,. 3'H ::< < :~.~.: ~F?'.$f r HY6'rr r,7 r!/ G'f F q: Hre 7 . Tax Rate 7 X ~ ~ ys ~/r `~.ff~s'y ff~f.,•s~~y off f }%F~ •~.n`,~'f~~i'~'% :'~ : ~''%`~~ s~>%4•: ~~ryk''~~..F i •., fry 'IO:'.sF•:s /;.' '3• 3 f 1%"'¢9.:' ~ r,' :'g.'s' 9 ~x't' i !'rF '• ~ r l ' ~ l r,'., 'r,. ',n;!f ,/ f f:'tl:`:`•f'Ff;~%:fF, f:!r.•n, ~~~ O :,ff fa,,,t/f~~:: ~' ~ fr~/?` r ~rf."3'..f ..F'.K~'r(,,~~! f 8 . Tax Due 8 $ Z- Q c Z y,4''<fk.'y%'``":~~:,:a:•~;.?:,~:,•Fr?:?;.~?'~.~r:s;F~":+;:ff~;`;a•". .y~Ffi:ffrr~:%`° ':: '•.r:rf:• ' S••' :~r:•f!;<s :9~:sF d: s.!'•:~;<:..d%::: r%..frnn;<.,>!?.'s.:? nf.:v::w:f:`if.r'~;??s•FFS,'fr.Y'!x 'f,.'.:::.;?:~•. .::fig 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 areGtreue, correct and omelet to the best of my knowledge and belief . HOME C ~ ~~ ) l J7~ ~~~ S e n `Z^~ /// WORK C ) 3- 7- 1 O TAXPAYE SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter 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 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 after l2/12/82, 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 •egistered 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 Cline 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 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 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. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: SCHARDT KIMBERLY D 605 S MAIN ST MARYSVILLE, PA 17053 -------- fold ACN ASSESSMENT CONTROL NUMBER ESTATE INFORMATION: SSN: 179-14-8711 FILE NUMBER: 2109-0736 DECEDENT NAME: BRUDOWSKY MARIAN L DATE OF PAYMENT: 03/09/2010 POSTMARK DATE: 03/08/2010 COUNTY: CUMBERLAND DATE OF DEATH: 07/24/2009 AMOUNT 09165682 ~ $29.20 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 1 181 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT 529.20 INITIALS: JN RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 012432