HomeMy WebLinkAbout03-0693CONMONHEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF IND/VZDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1645 EX AFP C09-06)
ZNPORHATZON NOTICE
AND
TAXPAYER RESPONSE
F'rLE NO. 21 -~0% -~3
ACN 0512825q
DATE 08-08-2005
::,.. . TYPE OF ACCOUNT
EST. OF DOROTHEA J DEMERICE [] SAVINGS
S.S. NO. 555-20-$523 [] CHECKING
'{::)3 i:,~g 21 "1;: :..c~ATE OF DF. AT}[ 05-02-Z003 [] TRUST
~'; COUNTY CUMBERLAND [] CERTIF.
REMIT PAYMENT AND FORMS TO:
MARTLYN J ELLTOTT t,,: REGISTER OF MILLS
lqO 16TH ST ,-,,. , CUMBERLAND CO COURT HOUSE
NEN CUMBERLAND PA 17070~i09 CARLISLE, PA 17013
ALLFZRST FINANC/AL SERV has provlded the Department Nith the information listed belch Hhich has been used in
calculating the potentiat tax due. Their records indicate that at the death of the above decedent, you Hera a joint oHner/benaficiary of
this account. If you foal this information is incorrect, please obtain Hritten correction from the financial institution, attach a copy
to this form and return it to tho above address. This account is taxable in accordance aith the Inheritance Tax LaHs of the CoeeonHoalth
of Pennqyluan~a- Questions may be ansHered by calling (717) 787-8~27.
COMPLETE PART 1 mELON a # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accoun~ No. 0057702667 Data 0q-29-1991
Established
Accoun~ Balance 969.51
Percan~ Taxable X 50.000
TaxAe°Un*Ra~eSubjec* to Tax X qSq .15'76 ~ I I~7~,~
Po*en~ial Tax Due 72.71
To insure proper credit to your account, tho
(2] copies of this notice must accompany your
payment to the Register of Nllls. Make check
payable to: "Register of #ills, Agent".
NOTE: If tax payments are made Hithin three
($) months of the docadant's date of death,
you may deduct a SZ discount of the tax due.
Any inheritance tax duo Hill become delinquent
nine (9) months after tho date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
A. r~The above information and tax due is correct.
L~
l. You may choose to remit payment to the Register of Hills Hith tho copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Mills and an official assessment Hill be issued by the PA Department of Revenue.
B. ~-~ The above asset has been or Hill be reported and tax paid Hith the Pennsylvania Inheritance Tax return
to be filed by the dacedent's representative.
C. ~The above information is incorrect and/or debts and deductions Here paid by
you.
· ~ou must completa PART Iii and/or PART 131beloH.
i i
PART Tf yOU indicate a differen~ ~a~ ra~e~, p,~eas,~ s~a~e your
~ rela*ionsh[p 4:0 deceden*: _(~.~(l ~ V~ .~.
TAX RETURN -COMPUTATZON OF TAX ON JOTNT/TRUST ACCOUNTS
7
LINE 1. Date Established
2. Accoun~ Balance
$. Percen~ Taxable
q. Aeoun~ Subjac~ ~o Tax
5. Dab~s and Deductions
6. Aeoun~ Taxable
7. Tax Re~a
8. Tax Due
PART
DATE PAID
DE~TS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury~ I declare that ~he fac~s I have reported above arm ~rue~ correc~ and
coeple~:e 4:o *he bee* of my knowledge and belief. HOME C )
TAXPAYER S[GN~URE TELEPHONE NUHBER
GENERAL INFORMATION
1. FAILURE TO RESPOND HILL RESULT ZN AN OFFICIAL TAX ASSESSNENT with applicable interest based on information
submitted by the financial institution.
2. Inheritance tax becomes delinquent nine months after the decadant's data of death.
5. A joint account is taxable even though the decedent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
S. Accounts established jointly between husband and wife more than one year prior to death are net taxable.
6. Accounts held by a decedent "in trust for" another or others ara taxable fully.
REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE
1. BLOCK A - Tf the information and computation in the notice are correct and deductions ara not being claimed, place an "X"
in block "A" cf Part I of the "Taxpayer Response" section. Sign twa copies and submit them with your check for the amount of
tax to the Register of Hills of the county indicated. Tho PA Department of Revenue will issue an official assessment
(Fora REV-lDO8 EX) upon receipt of the return from the Register of Hills.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid uith the Pennsylvania Inheritance
Tax Return filed by the dacedent'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 Z80601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts
according to the instructions below. Sign twa copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-15q8 EX) upon receipt
of the return from the Register of
TAX RETURN - PART Z - TAX COHPUTATTON
L IHE
l. Enter the data the account originally was established or titled in the manner existing at data of death.
NOTE: For a decedent dying after IZ/Iz/az: Accounts which the decedent put in joint names within one (l) year of death are
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (ww) appears before your first name in the address portion of this notice, the $3,0n0 exclusion
already has been deducted frae the account balance as reported by the financial institution.
Enter the total balance of the account including interest accrued to the date of death.
The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the dacedant's death:
1 DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUHBER OF X 100 PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OHNERS
Example: A joint asset registered in the name of the decedent and two other persons.
I DIVIDED BY 3 (JOINT OHNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within Dna year of the dacedent's death or accounts owned by the decedent but held
in trust for another individual[s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OHNERS 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 Z [SURVIVORS) = .50 X lno = 50Z [TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line
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.
O,~e of Death I Spouse I Lineal I SiblAng I Collateral
07/01/9q ~o 12/$1/9q
01/01/95 ~o 06/30/00
07/01/00 ~o presen~ OX
mThe tax rate imposed on the nat value of transfers free a deceased child twenty-one years of age or younger at
death to or for the use of a natural parent, an adoptive parent, or a stapparant of the child is OZ.
The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendants" includes all children of the
natural parents and their descendants, whether or nat they have been adopted by others, adopted descendents and their descendants
and stap-descendants. "Siblings" ara defined as individuals who have at least one parent in common with the decadent, whether by bleed
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLATHE9 DE])UCTTONS - PART 5 - 9Ei~TS AN]) ])EDUCTTONS CLATHED
Allowable debts and deductions ara 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, usa plain paper S I/Z" x ll". Proof of
payment amy be requested by the PA Department cf Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 002928
ELLIOTT MARILYN J
140 16TH STREET
NEW CUMBERLAND, PA
17070-1109
........ fold
ESTATE INFORMATION: SSN: 535-20-3523
FILE NUMBER: 2103-0693
DECEDENT NAME: DEMERICE DOROTHEA J
DATE OF PAYMENT: 08/21/2003
POSTMARK DATE: 08/1 9/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 05/02/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
03128234 $21.82
REMARKS:
MARILYN J ELLIOTT
TOTAL AMOUNT PAID:
$21.82
SEAL
CHECK# 3487
INITIALS: SK
RECEIVED BY.'
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DZ¥ZSZON
DEPT. 280601
HARRTSDURG, PA 17128-06nl
HARILYN J ELLIOTT
1~0 16TH ST
NEH CUHBERLAND
COHHON#EALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT. ALLORANCE OR DISALLOHANCE
OF DEDUCTZON~, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-15gi8 EX ~kFP
PA 17070-1109
DATE 10-21-2003
ESTATE OF DEHERICE
DATE OF DEATH 05-02-2005
FILE NUNBER 21 03-0695
COUNTY CUHBER LAND
SSN/DC 555-20-5525
ACN 0312823~
I Amoun'l: Re, m J.'l:'l:ed
DOROTHEA J
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOHER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOHANCE OR DZSALLOHANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE lO-II-ZOO3
ESTATE OF DEHERICE
DOROTHEA d DATE OF DEATH 05-02-2005 COUNTY CUHBERLAND
FILE NO. 21 03-0693 S.S/D.C. NO. 555-Z0-3523 ACN
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
0312823~
dOINT OR TRUST ASSET INFORHATION
FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERV ACCOUNT NO. 0057702667
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) T/HE CERTIFICATE
DATE ESTABLISHED 0~-29-1991
Account Balance
Percent Taxable X 0.500
Amount Subject to Tax ~8~.76
Debts and Deductions - .00
TaxabZe Amount ~8~.76
Tax Rate X .RS
Tax Due Z1.81
TAX CREDITS=
969.51 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
HITH YOUR TAX PAYHENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF HILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
08-19-2003 CD002928 .00 21.82
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ~
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
21.82
.01CR
.00
.01CR
PURPOSE OF
NOTICE:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TZ P.S.
Section 9140).
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADH/N-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the
reverse side.
-- Hake check or Boney order payable to: REGISTER OF HILLS, AGENT.
A refund of a tax credit, which was not requested on the tax return, may be requested by compIating an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of
the Register of Hills, any of the Z$ Revenue District Offices or by calling the special Z4-hour ansaering service
for fores ordering: 1-800-$6Z-ZO50; services for taxpayers with special hearing and or speaking needs:
1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assmssment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81OZ1, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviaa Unit, DEPT. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6585. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent
discount of the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the totml of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same Banner end in the the Saab tiaa period as you would appeal the tax and interest
that has been assessed es indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164.
Ali taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from
calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest DaiLy
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000548 1987 9Z .000Z47 1999 7Z .00019Z
1983 16Z .000438 1988-1991 llZ .000301 ZOO0 8Z .000Z19
1984 11Z .DO0301 199Z · 9Z .000Z47 ZOO1 9Z .000247
1985 13Z .000356 1993-1994 72 .O0019Z ZOOZ 6Z .000164
1986 IOZ .DOOZ74 1995-1998 9Z .000Z47 ZOO3 SZ .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPATD X NUIJBER OF DAYS DELTNQUENT X DAILY TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of fha assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-11 62 EX(11-96)
CD 003545
FREY ROBERT M
5 S HANOVER STREET
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 181-32-3502
FILE NUMBER: 21 03-0993
DECEDENT NAME: BOLZE GERALDINE E
DATE OF PAYMENT: 02/1 O/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 11/11/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $4,496.00
TOTAL AMOUNT PAID:
$4,496.00
REMARKS:
SEAL
ROBERT M FREY
CHECK# 105
INITIALS: AC
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS