HomeMy WebLinkAbout03-07-12COMMONWEALTH OF PENNSYLVANIA REV-1182 EXI11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 015671
STOLTZ DAVID
48 ROUND RIDGE ROAD
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: SsN: 2e~-zz-zis2
FILE NUMBER: 2112-0284
DECEDENT NAME: STOLTZ DONALD H
DATE OF PAYMENT: 03/07/2012
POSTMARK DATE: 03/06/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 02/08/2012
12113762 ~ $232.47
TOTAL AMOUNT PAID:
REMARKS: DAVID STOLTZ
$232.47
CHECK#1185
INITIALS: WZ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
B
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 pennsyty
HARRISBURG PA 17128-0601
DEPAPTMENT OF aI
REY-1563 Elt ~FP
PENNSYLVANIA INHERITANCE TAX
~pt~~t~ INyF~~O ATION NOTICE
!r~,.fLU'Si~tiL ' AND FILE N0. 21 - ~~_6~C.f
2';j rt, ~,T , YER RESPONSE ACN 12113762 /
~R r~; ~~~ ~ DATE 02-24-2012
~8i1 MAR -7 Ph! 12~ 36
EST. OF DONALD H STOLTZ
CLERK Qr SSN 257-22-2192
QRPHArl~S vOURT DATE OF DEATH 02-08-2012
(~ p~ A'(~ /~(~ COUNTY CUMBERLAND
"`/ry{~~~,~~'v`° ,''" ' ~ REMIT PAYMENT AND FORMS T0:
DAVID H STOLTZ REGISTER OF WILLS
48 ROUND RIDGE RD 1 COURTHOUSE SQUARE
MECHANICSBURG PA 17055-9200 CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU provt dad 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 Jotnt owner/beneficiary of this account. If yDU are the Spouse 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 ypu must
notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" 1n PART 2.
If you believe the information is incorrect, please obtain written correction from the financial insti tutt on, 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 FILING AND PAYMENT INSTRUCTIONS
Account No. 101762-00 Date 05-04-1988 7o ensure proper credit to the account, two
Established copies of this notice oust accoapani.
Account Balance 32,625.75 pavaent to the ReBistsr of Wills. Make check
payable to "Raeister of Wills, Asent".
Portent Taxable X 16.667 ""-~
Amount Subject to Tax
5
437
73 NOTES If tax payments are made within three
,
. months of the decedent's date of death.
Tax Rate X .045 deduct a 5 portent discount on the tax due.
Potential Tax Due S 24 4.7 0 Any inheritance tax due will become delinquent
nine months after the date of death.
PART
CHECK
ONE
BLOCK
ONLY
above information and tax due is correct.
Remit Dayment to the Raeister of Wills with two copies of this notice to obtain
a discount or avoid interest, or return this notice to the Raeister of Wills and
an off ieial assessment will be issued by the PA Department of Revenue.
B. ~ The above asset has bean or will ba reported and tax paid with the Pennsylvania inheritance tax return
filed by the estate representative.
C. ~ Th• above info a ion is incorrect and/or debts and deductions were paid.
Coaplete PART ~ and/or PART 3^ below.
PART If indicating 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 ~
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions 5 -
6. Amount Taxable 6 ~
7. Tax Rate 7 X
8. Tax Due 8 S
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
Under penalties of perjury. I declare that the facts I reported above tta~re true, correct and
complete tIo tgh~e bepst~,of my knowledge and belief. HOME C - 1, ) ~ (~
~gnu;A, IY ~11..~ _ WORK ( )
TAXPAYER SIGNATURE X TELEPHONE NUMBER D T
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT LN AN OFFICIAL TAX ASSESSMENT with applicable interest based on info reation
subwitted by the financial institution.
2. Inheritance tax becowes tlelinquent nine wonths after the decedent's date of death.
3. A ioint account is taxable even when the decedent's nave was added as a wetter of convenience.
4. Accounts (including those held between husband and wife) the decedent put in joint naves within one year prior to
death are fully taxable.
5. Accounts established jointly between husband and wife wore than one Year prior to death era not taxable.
6. Accounts held by a decedent "in trust for" another or others are fully taxable.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPDNSE
1. BLOCK A - If the inf orwation and calculation in the notice are correct and deductions are not being claiwed, place an "X"
in Block A of Part 1 of the "Taxpayer Response" section. Sign two copies and subwit thew with a check for the awount of
tax to the register of wills of the county indicated. The PA Departwent of Revenue will issue an official assesswent
(Forty REV-1546 EX) upon receipt of the return frow 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
Lax 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 inforwation is incorrect and/or deductions are being claiwed, cheek Block C and cowplete Parts 2 and 3
according to the instructions below. Sign two copies and subwit thaw with your chock for the awount of tax payable to the register
of wills of the county indicated. The PA Departwent of Revenue will issue an official assesswent CForo REY-1540 IX) upon receipt
of the return 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 of ter l2/12/82, accounts the decedent put in joint naves within one veer of death are
fully taxable. However. there is an exclusion not to exceed sa,BBg per transferee, regardless of the value of
the account or the nuwber of accounts held.
If a tlouble asterisk (}s) appears before your first naae in the address portion of this notice, the 03,000 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 deterwined as follows:
A. The Dercenta9e taxable of joint assets established sore than one year prior to the decedent's death:
1 DIYIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF MULTIPLIED BY 100 = PERCENT TAXABLE
JOINT OWNERS SURVIYING JOINT OWNERS
Exawple: A joint asset registered in the nave of the decadent and two other persons:
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) _ .167 X 100 = 16.7 percent (TAXABLE TD EACH SURY IVOR)
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) Ct rust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT MULTIPLIED BY 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Exawple: Joint account registered in the nave of the decedent and two other persons and established within one year of death by
the decedent.
1 DIVIDED BY 2 (SURYIVORS) _ .50 X 100 = 50 percent (TAXABLE FOR EACH SURVIYOR)
4. The awount subject to tax Cline 4) is deterwined by wultiplving 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. Tha awount taxable (Line 6) is deterwined by subtracting the debts and deductions (Line 5) frow the awount subject to tax (Line 4).
7. Enter the appropriate tax rate [Line 7) as deterwined below.
^Tha tax rate iwoosed 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 steDPe rent of the child is 0 percent.
The lineal class of heirs includes grandparents, parents, children and other lineal descendents. "Children" includes natural chiltlren
whether or not they Nava boon adopted by others, adopted children and step children. "Lineal descendents" includes all chiltlren of the
natural parents and their descendents, whether or not they have been adopted by others; adopted descendents and their doscendents;
and stev-dascendants. "Siblings" are defined as individuals who have et least one parent in cowwon with the decedent, whether by blood
or atloption. The Collateral class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Allowable tlebts antl deductions are date rwinetl as follows:
Date of Death Spouse Lineal Sibling Collateral
07/01/94 to 12/31/94 3 percent 6 percent 15 percent 15 percent
,.0,1/_pl/95 to 06/30/00 0 percent 6 percent 15 percent 15 percent
07/O1/00 to present 0 percent 4.5 percent a 12 percent 15 Percent
A. You are lapel ly resvansihle for vavwent, or the estate subject to administration by a personal representative is insufficient
to pay the deductible itews.
B. You actual lv paitl the debts after the death of the decedent and can furnish Droof of paywent.
C. Debts being claiwed ^ust 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 Departwent of Revenue.
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