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HomeMy WebLinkAbout03-15-10~' ?t X d +i a a ,: y~ ~~ .~ ~ .t -,:.~ .. Y...y :~ ~Jv l: Iwnn~ ~~ t''~, ;K~ `',. 4 i° i1~. i'~tf 1, N ~,; O ~~ ~.., N .-~ ~... x ~~ ~W~~ ^, ~~ ~ ~~: V ~~ ~~ 3 ~~ `~, ~ ~'' ~~~ s~% ~U l~rl~~~ ~~3~V~~ti~~la ~U~ ~~~~~ ZZ ~il ~d Sl ~~'~~1D1 t ;,., f• ,-~ ~ a ~- , -~~ ~= .,t..° ~,,` t ., ~+~ ++ ~{{ ~~i i•~~ '~ u~ •rM! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES Po Box 280601 HARRISBURG PA 17128-0601 ,~ ~` I REV-1543A AFP C7 CW .._ INFORMATION NOTICE _ _.,~.-, --~- r,~AND ` ' 'T:~I~~?~V~@R RESPONSE °-''~ ;r I - i- ~ ~ ~, ~ 1y ~;.. , FILE NO. 21 ~(~ U i•2 3 ACN 10500208 DATE 02-09-2010 TYPE OF ACCOUNT ~Q i~ ~~ ~ ~ P~ E~'T~~F MAE E HARTMAN ^ SECURITY S.S. N0. 202-20-1624 X^ sEC ACCT ~r DATE OF `~ ~ ~ ~~ DEATH O 1- 09 - 2010 ^ sTOCK : t . .. ('tt': C)i...f ~r,? ~ ~ '~~}~ Q~Q~JNTY ` ' CUMBERLAND ^ B O N D S rtfSµ t f~f,, ~a~ _' ~,~11. ~~Y ~~~i;`• REMIT PAYMENT AND FORMS T0: VANESSA A HARTMAN p REGISTER OF WILLS 556 EAST MAPLE STREET 1 COURTHOUSE SQUARE CLEONA PA 17 042 CARLISLE PA 17013 AMERIPRISE FINANCIAL has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, You were a beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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 Questions may be answered by calling C717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 15169017 To insure proper credit to your account, two (2) copies of this notice must accompany your 25, 942.00 payment to the Register of Wills. Make check DOD Valuation Payable to: Register of Wills, Agent Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax 25, 942.00 (3) months of the decedent's date of death, Tax Rate X .045 you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 1 s 167.39 nine (9) months after the date of death. PART TAXPAYER RESPONSE r:Irr !'!rr it :,;2,'6~:;... , •.. ,,.: rf7r ~`t~ , y.<; ~:k` © ice.%r : f if >'f. r .: fF ~`' :f:` :'%.rr' ",y',•i;'i, : `y x, .:`:r:• "r.~.` r..f . ::::/°r.i:•:'• r'''r'`` r F,~ 'J~:e `.r "'?'' ~"~~r!"':;5/. .~F~,./.~.•:~%'%.;:rY, :.',. `,~'/`'ef': r::n.' .C,'r:.%l/ ~ '9'Ya°c?r .`r ;yy.,sc,':~},:';! !'! f' .6':.:rr : ~¢ . !: r :`%:J:. F..rr`:.., a r?.,~'.::'.:•~:r.•. f•S.:.o` . s`Ar` F `: `:l `vY:.l %. ,..fJr.. r n; 'r,.fi''`/.',.°oo„'.+.~:..`:rya ,` ..n . .pia`. ~.;r r.: .A'/:.'~. .H.r:r'^~,`::yir r. .::~: ::r.t,::.:.rr:!:~:.•:~io/r/fn.,li:.'o.`:ti'Te~.f. A. The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of 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 ONLY to be filed by the decedent's representative. C. ^The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If ou indicate a different tax rate "'"'':~'~':;:`%"' ,%.";"i/`' ! ':" y :r`r, PART y , please state your ,~%~i,~ if;~~~-~l+r+`•''~'"~ ~'/'~r' ;r'` •~ relationship to decedent: ~~~'~ }r~;%%~' r•F ~ •~'. , .., : TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS~ ,'~~ ~'~ '~ `~+ f / ~•f' Hf l~;~y"r•,:;`~~f'~4`Y.i~<:'v~.~ f ~f"' R.~, ` .+'9` ' •: LINE 1. DOD Valuation 1 .<•:~: rs, ... ,.~.r ,r «i •„ ::f.~~y'~run• .. 2. Percent Taxab pa..~`~'~!'>%~<~k%%~~y`.':`.,r~~•;'f4':y` '' ~'~'• %~`f..f;'.y/!:F'' ~is:f:'; :`%s:G''::~r ~ ' ia`%Ji'; ~•':~%i`~:% `!. k r J , ~s•C !/ 3 . Amount Subject t o Tax 3 ~:;~rr~l.:,, ~' ".'•.~`.~"` ~%:~:~i" , •,~/ t .! h, '~ '~'•' '~` ~'~` `,r`'.{~:,'.:~''~a.?in:s"r.:..fF~~%~?`'~3::~%:d''~.5,y?;','~~;~~`'~`~o r~cs• r ;~ :,r~. :r 4. ~~r?,:~~>.°;f~: r`!/,.ri<srorflG`"'•?'Fsbra`•,:~``.••"•+:'r''`/``F~~'~S'` r'' „~ °':~' Debts and Deductions 4 - /'~ ~ ~~„``~''~<.:':~<,~~:r. ~q` ~"`~ ' r'~ ~°' '~?%i%''` t~?c'.~iI "`i5%'~~:~~;f .tr~f*;"r•!f%'~%rr':~,;~,,: ~ •~y .,I:i'r.'ri~:`,'•s~„•,~:~'yy rh 5. Amount Taxable 5 ~~~ f ~''' ~• %'r ~• ~` 6 . Tax Rate rN+r~fl',y ~/:mss?'~ .~~y ~y; ;~ rf. ~'.~,~ r ,s, ~,.~'..s.': ~' `ifi`: ~!3' pry ''sr >;3 ~`i' ! ,~~h rrr' rs '.h `;.~ ~,.,, .c•' is 7 . Tax Due 7 ~yy~ ~'~'~ ~~i:•~l~~1.:3'~`~"`~'.`''r ~~~~3~`9.°.~'r!~i ,y? `"~. .~'' :j ,•,.s r,~ ~•..,; PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, orrect and lete to the b of my kno edge and belief. HOME C ~~ a-~ WORK C _ ) J Q AXPAYER SIGNAT RE TELEPHONE NUMBER DAT IUINL ~tnier on ~lne 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 transfer agent. 2. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. Assets held by a decedent "in trust for" another or others are taxable fully. 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 your 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. Do not use the envelope provided. 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 decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-D601 in the envelope provided. 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. Do not use the envelope provided. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the total balance of the account including interest accrued to the date of death. 2. The percent taxable assets owned by the decedent but held in trust for or payable to another individual(s) (beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF BENEFICIARIES X 100 = PERCENT TAXABLE Example: Assets registered in the name of the decedent in trust for two other persons... 1 DIVIDED BY 2 (BENEFICIARIES) _ .50 X 100 = 50% (TAXABLE FOR EACH BENEFICIARY) 3. The amount subject to tax Cline 4) is determined by multiplying the account balance Cline 2) by the percent taxable Cline 3). 4. Enter the total of the debts and deductions listed in Part 3. 5. The amount taxable Cline 6) is determined by subtracting the debts and deductions Cline 5) from the amount subject to tax Cline 4). 6. Enter the appropriate tax rate Cline 7) as determined below. A. For dates of death occurring after 6/30/94, the tax rates for transfers to spouses are as follows: 1. Dates of death on or after 7/1/94 and before 1/1/95 the rate is 3%. 2. Dates of death on or after 1/1/95 transfers to spouses will be taxed at 0% tax rate. Note: For dates of death prior to 7/1/94 transfers to spouses are taxable at 6%. B. Transfers to lineal descendants including father, mother, son, daughter, grandchildren, son-in-law, daughter-in-law, stepchild and their issue are taxable at six percent C6%). A date of 7/1/2000 and after are taxable at four and a half percent C4.5%) . C. Transfers to siblings will be taxed at twelve percent C12%) for dates of death on or after 7/1/2000 . D. Transfers to all others including Uncle, aunt, nephew, and niece are taxable at fifteen percent C15%). E. For dates of death on or after 7/01/2000, transfers from a child Cage 21 or under) to a natural parent, adopted parent or step-parent are taxable at 0%. F. If you change the tax rate, please specify your relationship to the decedent in the area provided. 7. The amount of tax due Cline 8) is determined by multiplying the amount taxable Cline 6) by the tax rate Cline 7). CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are 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 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 plain paper 8 1/2" x 11". 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: HARTMAN VANESSA 556 E MAPLE ST CLEONA, PA 17042-2535 -- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 202-20-1624 FILE NUMBER: 2110-0123 DECEDENT NAME: HARTMAN MAE E DATE OF PAYMENT: 03/ 15/2010 POSTMARK DATE: 03/ 1 2/2010 COUNTY: CUMBERLAND DATE OF DEATH: 01 /09/2010 REV-1162 EX~11-96) NO. CD 012461 ACN ASSESSMENT AMOUNT CONTROL NUMBER 10500208 ~ $1,109.02 TOTAL AMOUNT PAID: REMARKS: CHECK# 0761 SEAL INITIALS: JN $1,109.02 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS