HomeMy WebLinkAbout01-12-12 (4)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0801
RECEIVED FROM:
COOK DALLAS E
100 HUNKEY HOLLOW ROAD
DUNCANNON, PA 17020
1oa
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1182 EXI11-961
NO. CD 015445
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: ssN: iss-az-a~oa
FILE NUMBER: 211 1-1294
DECEDENT NAME: STONER SHIRLEY C
DATE OF PAYMENT: 01 / 1 2/201 2
POSTMARK DATE: 01 / 1 1 /201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 2/ 2011
REMARKS: DALLAS COOK
CHECK# 2849
SEAL
111.77304 ~ 5304.09
TOTAL AMOUNT PAID:
INITIALS: WZ
5304.09
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~ PENNSYLVANIA INHERITANCE TAX
[ ~.NFORMATION NOTICE FILE N0. 21 - 1 ~ ~ ~a9y
BUREAU OF INUIV IDWIL TAXES ~ '_~ i~ 1:, fly, AND
PD aDx zag6gl penr~fl~~ ~jt ACN 11177304
HARRISBURG PA 17128-0601 bEpARTNENr~F,awENUe r',~! ~ TAXPAYE R RE S P O N S E
~~~ DATE 11-24-2011
aEY-1563 ~i~~aFP'~ita5-1~11
Cl.ERi~ t.i!'
ORPC~AN t,,r ~(7U~~Pa
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DALLAS E COOK
100 HUNKEY HOLLOW RD
DUNCANNON PA 17020-9728
EST. OF SHIRLEY STONER
SSN 188-32-4704
DATE OF DEATH 11-12-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMSTO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAYINGS
CHECKING
TRUST
CERTIF.
RIVERVIEW NATIONAL BANK provided the department with the information below, which was used in caicuiating the inheritancetax due.
Records indicate that at the death of the above-named decedent, you were a ,1 Dint owner/beneficiary of this account. If y0U are the Sp0U5e Of the
deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must
notify the department of your relationship to the deceased by checking Box C 1n PART 1 below and writing "spouse" in PART 2.
If yyou believe the information is incorrect please obtain written correction from the financial fnstituti on, attach a copy to this form and return
~_,- _ it to the. above address .. Please cg~.11 717-787-8327 yi th gues ti ons.__ -. _ _ .._.- ---_
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 3067664
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
Date 06-03-2008
Established
$ 15,204.40
X 16.667
$ 2,534.12
X .12
$ 304.09
To ensure proper credit to the account, two
copies of this notice oust aeeompa3ry
payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
NOTE: If tax payments are matle within three
months of the decedent's date of death.
deduct a 5 percent df scount on the tex due.
Any inheritance tax tlue will become dalineuent
nine months after the data of death.
C. ~ Th• above inf orma ion is incorrect and/ordebts and detluctions ware paid.
Complete PART ~2 and/or PART 3~ below.
PART If Sndlcating a different tax rate, please state
relationship to decedent:
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 ~
S. Percent Taxab l,e - - 3 - X ~ - ~. - -- - ~.- -_ -
4. Amount Subject to Tax 4 ~
5. Debts and Deductions 5
6. Amount Taxable 6
7. Taz Rate 7 X
8. Tax Due 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE P AID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that tho facts I reported above are true, correct and
c eta the bast o y kn wledge and belief. ~ ~ p
~/~' HOME C ~~~ ) }~ 3 / 7Z
DATE
A. ~ Tha 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 return this notice to the Register of Wills and
ONE an official assessment will be issued by the PA Department of Revenue.
B L DC K B. ~ Tha above asset has been or will 6e reported and tax paid with the Pennsylvania inhe ritanee tex return
ON L Y filed by the estate representative.
GENERAL INFORMATION
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information
submitted by the financial institution.
Inheritance tax becowes tlalinquent nine months after the decedent's date of death.
A joint account is taxable even when the decedent's name was added as a wetter of convenience.
Accounts (including those held between husband and wife) the decedent put in joint names within one Year prior to
death are fully taxable.
Accounts established jointly between husband and wife wore than one year prior to death are not taxable.
Accounts hold by a decedent "in trust for" another or others are fully taxable.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and calculation 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 IX) upon receipt of the return from the register of wills.
2. BLOLK B - If the asset specified on this notice has been or will be reported and tax Daid 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. BLOCK C - If the notice inf oreatipn 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 subeit thew with your check for the awount of tax payable to the register
of wills of the county indicated. The PA Department of Revenue will issue an official assesswent IFOrw REV-1548 IX) upon receipt
of the return frog the register of wills.
TAX RETURN - PART 2 - TAX CALCULATION
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 of ter 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 C3.O06 per transferee, regardless of the value of
the account or the nuwber of accounts held.
If a double asterisk Isr) appears before your first Wawa in the address portion of this notice, the 13.000 exclusion
was deducted frow 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 date Wined 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 188 = PERCENT TAXABLE
JDI NT OWNERS SURVIVING JOINT OWNERS
Exawple: A joint asset registered in the name of the dacadant and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TD 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 106 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Exawple: Joint account registered in the nave of the. decedent and two other ve rsons and establishod within one year of death by
the decedent.
1 DIVIDED 8V 2 CSURV IVORS) _ .50 X 100 = 56 percent (TAXABLE FOR EACH SURVIVOR)
4. The awount subject to tax (Line 4) is tleterwined 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 awount taxable (Line 6) is date reined by subtracting the debts and deductions (Line 5) frow the awount subject to tax Qine 4).
7. Enter the appropriate tax rate Cline 7) as date rwinetl below.
^The tax rate imposed on the net value of transfers frow 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 hairs includes grandparents, parents, children and other lineal descendants. "Children" includes natural children
whether or not they have been adopted by others, adopted children and stab children. "Lineal de scentlent s" 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-de scandants. "Siblings" are defined as individuals who have at least one Derent in cowwon 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 detereined as follows:
Date of Death Spouse Lineal Sibling Collateral
07/O1/94 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
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 void the debts after the death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itewized fully in Part 3. If additional space is needed, use 8 1/2" x 11" sheet of paper. Proof of
paywent way be requested by the PA Depa rtwent of Revenue.