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06-27-12
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 12-0321 Po sax zag6gl ~ W -. ACN 12502691 HARRI59URG PA nlzs-osol _ ir~'}~.l'~A~AYER RESPONSE eev sa 'exr~yin ~ ,,; ~ ~; DATE 06-15-2012 t+4 ~ _<. ; TYPE OF ACCOUNT 212 JUN 27 AHla EST. OF HARRY D JONES ^ SECURITY S.S. N0. 175-18-2025 ® sec acct ~ DATE OF DEATH 02-24-2012 ^ srocK ~ ~ COUNTY CUMBERLAND ^ eoNDs /~ C~Pt-s'=~ ~'S COU=; r `jtJ~~~ ~'~ F,' REMIT PAYMENT AND FORMS T0: SHELLY A SCHUBERT REGISTER OF WILLS 24694 NETTLE MILL SQ 1 COURTHOUSE SQUARE STONE RIDGE VA 20105-2995 CARLISLE PA 17013 VANGUARD has provided the Departaent with the inforaation listed below which has been used in caleulatinB 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 inforaation is incorrect, please obtain written correction frog the transfer agent, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Cowaonwealth of Pennsylvania. Questions say be answered by calling 0717) 787-8327. COMPLETE PART 1 BELOW ~ * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 09892445777 7o insure proper credit to your account, two C2) copies of this notice oust accoapany your DOD Yaluation 122 ~ 782 • 31 payaent to the Register of Wills. Meke check vavable to: "Register of Wills. Agent". Percent Taxable X 100.00 NOTE: If tax oavaents are aade within three AIl10Unt SUbjeCt t0 TeX 122 ~ 782 • 31 (3) eonths of the decedent's data of death. Tax Rate x . 0 4 5 you aav deduct a 5X discount of the tax due. Aro: inheritance tax due will becowe delinquent Potential Tax Due 5,525.20 nine C9) eonths after the date of death. P~T TAXPAYER RESPONSE A. ^ Ths above inforaation and tax due fs correct. 1. You aav choose to resit pavaent to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or you say check box "A" and return this notice to the Register of C 0 N E ~ Wills and an off ieial assessaent will ba issued by the PA Departaent of Revenue. BLOCK B. ^ The above asset has been or will be revorted end tax paid with the Pennsylvania Inheritance Tax return ON L Y to be filed by the decedent's representative. C. ^ The above inforaation is incorrect and/or debts and deductions were paitl by you. Vou aust coaplete PART ^2 and/or PART ^3 below. PART If you indicate a different tax rate, please state your © relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS7 LINE 1. DOD Valuation 1 2. Percent Taxable 2 X 3. Amount Subject to Tax 3 4. Debts and Deductions 4 - 5. Amount Taxable 5 6. Tax Rate 6 x 7. Tax Due 7 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID WORK (7~3 ) ~'-aZyQG ~~~~~/ Under penalties of erjury, I declare that the facts I have reported above era true, correct and complete to the q'st o ali/ kpowlatlge_and belief. unu~ r 'ln~ ~ ~~~ 7~_7n i 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 thew with your chock for the a~ounY Hof tax to the Register of Wills of the county indicated. The PA Departwent of Revenue will issue an official assesswont (Form REV-1548 IX) upon receipt of the return frog the Register of Wills. Do not use the envelope providatl. 2. BLOCK B - If the asset specified on this notieo has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decetlent's representative, Place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one coon and return to the PA Departwent of Revenue. Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 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 thew 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 ease ssmant CFOrw REY-1548 IX) upon receipt of the return frog the Register of Wills. Do not use the envelope provided. LINE TAX RETURN - PART 2 - TAX COMPUTATION 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 re gisteretl 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 (line 2) by the percent taxable (line 3). 4. Enter the total of the debts and deductions listed in Part 3. 5. Tha amount taxable (line 6) is determined by subtracting thedebts and deductions Cline 5) from the amount subject to tax Cline 4). 6. Enter the appropriate tax rate (line 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 antl 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 tlates of death prior to 7/1/94 transfers to spouses are taxable at 6X. 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 (6Y.). A date of 7/1/2000 and after are taxable at four and a half percent I4.5Y.) . C. Transfers to slblings will be taxed at twelve percent (12%) for dates of death on or after 7/1/2000 . D. Transfers to all others including Uncle, aunt, nephex, and niece are taxable at fifteen percent (15Y.). E. For dates of death on or after 7/01/2000, transfers from a child (age 21 or under) to a natural parent, adopted parent or step-parent are taxable at 0%. F. If you change the taz rate, please specify Your relationship to the decedent in the area providatl. 7. The amount of tax due Cline 8) is determined by multiplying the amount taxable (line 6) by the tax rate (line 7). CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally era 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 REV•1182 EXI1 t-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL 7AXE5 DEPT. 200601 HARRISBURG, PA 1 7 1 28-060 1 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015992 SCHUBERT SHELLY 24694 NETTLE MILL SO. ALDIE, VA 20105 ACN ASSESSMENT AMOUNT CONTROL NUMBER •------ ford ------~ ~- ESTATE INFORMATION: SSN: 175-78.2025 FILE NUMBER: 2112-0321 DECEDENT NAME: JONES HARRY D DATE OF PAYMENT: 05/21/2012 POSTMARK DATE: 05/18/2012 CouNTY: CUMBERLAND DATE OF DEATH: 02/24/2012 REMARKS: CHECK#1000 SEAL 101 ~ 55,248.94 TOTAL AMOUNT PAID: 5 5, 248.94 INITIALS: HEA RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER SON V If7 W 0 M°° ~o M 0 C ~ o _ ~~ o ~ ~ ~ i. _ _ ~~ ~.~_ ~ ~ ~ ~ ~ ~ 7 ~, ®_' r ~ r_ ~ ~ 0 a ---~ o . ~ „~,,,,~,.,~ c .~ ..~'~ ~ ~. ~~~ ~- ~o ~~ ~~ -~ ~ ~~ ~~ ~~ ~- ~`'~' ~~ ~) ^^~ V / ~l ^ ' ~-- w \! ~ 6 ~~~ 1~ ' ""'f~ O ~~ s a d U ~~ t ~~ /\ _~ 6 v ., .~ ~~. S tli Ll) S Q" ..0 ~U ra IL O O O O r u'1 r-~ rl rl O 1 `-