HomeMy WebLinkAbout01-12-12 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0601
RECEIVED FROM:
COOK DALLAS E
100 HUNKEY HOLLOW ROAD
DUNCANNON,PA 17020
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1182 EX(11-96)
NO. CD 015444
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- folC
ESTATE INFORMATION: SSN: 1ss-32-4704
FILE NUMBER: 211 1-1294
DECEDENT NAME: STONER SHIRLEY C
DATE OF PAYMENT: 01/12/2012
POSTMARK DATE: 01 / 1 1 /201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 2/201 1
11177302 ~ 5934.52
TOTAL AMOUNT PAID:
REMARKS: DALLAS COOK
SEAL
CHECK# 2848
5934.52
INITIALS: WZ
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU Ok INDIVIDUAL TAXES
PO BOX 280601 pennsylvani~
HARRISBURG PA 17128-0601 pEFAarMENl of REVENUE
NEV-1543 E% •FP (05-11)
PENNSYLVANIA INHERITANCE TAX rr//
,,,,, INFORrMATION NOTICE FILE N0. 21-11 ~~ ~qT
L ~"~ ~ ~ ~ r ~' ~ ,[ (~ AND ACN 11177302
s f ~ TpXPA~YER RESPONSE
~-'-~~ DATE 11 -24-2011
T. OF SHIRLEY STONER
CLERK; ~= ssN 188-32-4704
ORPF~~.fv'S ~~URr DATE OF DEATH 11-12-2011
C())lQ~rq,~ /,r,~^ „~ COUNTY CUMBERLAND
'~ "`~ ~A REMIT PAYMENT AND FORMS T0:
DALLAS E COOK REGISTER OF WILLS
100 HUNKEY HOLLOW RD 1 COURTHOUSE SQUARE
DUNCANNON PA 17020-9728 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
® CERTIF.
RIVERVIEW NATIONAL BANK provided the department with the information below, which was used in calculating the inheritance tax due.
Records indicate that at the death of the above named decedent, you were a ,point owner/beneficiary of this account. If y0U are the SpOUSe Of Lh!
deceased and any amount other than zero 1s reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your retatlonshtp to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2.
If you believe he information is incorrect, Dlease obtain written correction from the financial institution, attach a copy to this form and return
it to the above address. Please call 717-787-8327 with Questions.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FIi:IN6 AND"'PAYMENT INSTRUCTIONS
Account Na. 3065633 bate 02-05-2008 To ensure prover credit to th• account, two
Established copies of this notice oust accompany
Account Balance S` 46,724.91 payment to the Regi star of Wflls. Make cheek
payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subioct to Tax j` 7,787.64 months of the decedent's data of death,
lax Rate X 1 2 deduct a 5 percent discount on the tax due.
Arot inheritance tax due will become delinausnt
Potential TeX Due $ 934.52 nine months after the date of death.
PART TAXPAYER RESPONSE
0
A. ~ The above info nation and tax tlue is correct.
Remit pevment to the Register of Wills with two eoples of this notice to obtain
CHECK a discount or avoid interest, or return this notice to the ReOistar of Wills and
C 0 N E ~ an off ieial assessment rill 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
ON L Y filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions ware paid.
Complete PART ~ end/or PART ~ below.
PART If indicating a different tax rate, please state
ralatlonship to decedent:
TAX RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 $
3. Portent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deduetlons 5
6. Amount Taxable 6 ~
7. Tax Rate 7 X
8. Tax Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
,utY+-~.c- ~~x9~- WORK C~7t9 ~ ~0 pi -O10~ ~`L~~4^/2
I R SIG URE TELEPHO NUMBER DATE
Uln~d~er penalties of perjury. I declare that the facts I reported above are true, co(r~rect~yand/~
~oBplltr~ to the best of my Jr~owle~ge and belief. 41f1MF C ~/~ ~ S'C 1i~1 ~ 77 /
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with avglicable interest basetl on information
subwitted by the financial institution.
2. Inheritance tax becomes delinquent nine months after the decedent's tlate of death.
3. A joint account is taxable even when the decedent's nawe was added as a wetter of convenience.
4. Accounts (including those hold between husband antl wife) the decedent put in joint naves 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 I - TAXPAYER RESPONSE
1. BLOCK A - It the inforwation and calculation in the notice era 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 subwit thee with a check for the count of
tax to the register of wills of the county indicated. The PA Department of Revenue will issue an official assessment
(FOM REY-1546 EX) upon receipt of the return frog 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 two
copies and return to the register of wills of the county indicated.
3. 6LOCK C - If the notice information is incorrect antl/or deductions are being claiwed, check Block C and cwDlete Parts 2 and 3
according to the instructions below. Sign two copies and submit thew with your cheek For the awount of tax payable to the register
of wills of the county indicated. The PA Department of Revenue will issue an off ieial assessment (Form REV-1548 EX) upon receipt
of the rota rn frow the register of wills.
TAX RETURN - PART 2 - TAX CALCULATION
LINE
1. Enter the date the account originally was established or titled in the wanner existing at date of death.
NOTE: For a decedent who died after l2/12/82, accounts the decedent put in joint naves within one year of tleath are
fully taxable. However, there is an exclusion not to exceed 83.000 gar transferee, regardless of the value of
the account or the nuwber of accounts held.
If a double asterisk (rx) appears before your first nawe in the address portion of this notice, the 83.000 exclusion
was deducted from the account balance as reported by the finanef al institution.
2. Enter the total balance of the account including interest accrued to the data of death.
3. The percentage of the account that is taxable to each survivor is deterwined as follows:
A. The percentage taxable of joint assets established wore than one rear 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 nawe of the decedent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TA)fABLE 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 intli vi duel(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Exawple: Joint account registered in the naae 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 awount subject to tax (Line 4) is deterwined 6y ^ultiplyine the account balance (Line 2) by the percent taxable Cline 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. Tha awount taxable (Line 6) is deterwinetl by subtracting the debts and deductions (Line 5) from the awount suhj act to tax (Line 4).
7. Enter the appropriate tax rate Cline 7) as da tarwined 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
Tha tax rat' iwposed on the net value of transfers from a deceased child 21 nears of ape 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.
Tha 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. ^Siblinps^ are definod as individuals who have at least one parent in cormon with the decedent, whether by blood
or adoption. The Collateral ~eIass of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deterwinetl as follows:
A. You are legally responsible for payment, or the estate subject to adwinistration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the tlebts after the death of the decedent and can furnish proof of Daywent.
C. Debts being claiwed ^ust be itemized fully in Pert 3. If additional space is needed, use 8 1/2" x 11" sheet of paper. Proof of
payment way be requested by the PA Department of Revenue.
e,l- !,i
v
~ ~.
~~ ~ ~
~
~ 'r..
~
~1
~`~'' ~
~ ~'4
J
'`v
~
~ o
~~
~
ca
~
~... ~
m
i~
.~.
~-?
.~
~..
s
s
;?
i
y/^,'
F
~~`;