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Home My WebLink About10-16-12.~!-I~.-t11~. ' Inheritance Tax ~ pennsylvan~a BUREAU OF INDIVIDUAL TAXES Penns Ivania DEPARTMENT OF REVENUE PO BOX 280601 ~ t' '-~f ~~ ~~ormation Notice ~', ~,.~~~ i I $,. .-`~~. "-" --'~ REY-1543 EX DocEXEC CD8-12) HARRISBURG PA 17128-0601 fir i~.\ F~ 7 {~~ .. -Taxpayer Response FILE N0.2170 `r r:E_..,,,=-' ~- ACN 12155406 DATE 10-08-2012 ~, RICHARD D PICKEL 742 VALLEY ST ENOLA PA 17025-1618 o~,~-~~r~~~~~J .~'~a ,11 f f, C~~~F.;~~,~~l.t Estate of RICHARD D PICKEL SSN 161-34-2230 Date of Death 09-26-2012 County CUMBERLAND Type of Account Savings X Checking Trust Certificate s 1sT Fcu rovided the department with the information below indicating thadt at the death of the MEMBER p above-named decedent you were a joint owner or beneficiary of the account identifie Remit Payment and Forms to: Account No. 174494 REGISTER OF WILLS Date Established 04-24-1998 1 COURTHOUSE SQUARE Account Balance $ 349.34 CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $ 58.22 Tax Rate X 0.045 NOTE*: If tax payments are made within three months of the Potential Tax Due $ 2.62 decedent's date of death, deduct a 5 percent discount on the tax With 5% Discount (Tax x 0.95) $ (see NOTE*) due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1: Please check the appropriate boxes below. 1 A No tax is due. g ~ The information is correct. C ~ The tax rate is incorrect. (Select correct tax rate at right, and complete Part 3 on reverse.) D ~ Changes or deductions listed. E ~ Asset will be reported on inheritance tax form REV-1500. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. The above information is correct, no deductions are being taken, and payment will be sent with my response. Proceed to Step 2 on reverse. Do not check any other boxes. 4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. 12% I am a sibling of the deceased. 15% All other relationships (including none). The information above is incorrect and/or debts and deductions were paid. Complete Part 2 and part 3 as appropriate on the back of this form. The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. ,~ ~,l PART 2 Debts and Deductions Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 8 1/2" x 11"sheets of paper.) please obtain a written correct on fr m thelfinancial~institut on~a d atta hit to this fo m )' or percent taxable (Line 3), 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First, determine the percentage owned by the decedent. i. Accounts that are held "in trust for" another or others were 100% owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100% divided by the total number of owners including the decedent. (For example: 2owners = 50%, 3 owners = 33.33%, 4 owners = 25%, etc.) b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state your relationship to the decedent: UffiCial USe Only ^ AAF 1. Date Established 1 PA Department of Revenue 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 1 4. Amount Subject to Tax 4 $ ~ 5. Debts and Deductions 3 5 - 4 6. Amount Taxable g $ ~ 7. Tax Rate ~ X 6 8. Tax Due 8 $ 7 9. With 5% Discount (Tax x .95) 9 X 5iep 1: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the fr along with a check for any payment you are making. Checks must be made payable to "Register of Wills, Agent." Do Hoff this form, payment directly to the Department of Revenue. send Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of m kn belief. -~''~ y owledge and ~ %' ~ 4 Work Home ~1 ? - ~~<~ ~. 3c~ ~ `7 Tax-payer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGIST DEPARTMENT OF REVENUE DISTRICT OFFICE, ER OF WILLS, PA 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEART ERITANCE TAX DIVISION AT ONLY. 1-800-447-3020 NG AND/OR SPEAKING NEEDS Date Paid Pavee ~ .. F,..; ~„€ ~ ~. ~~yy ~-t T"J irir~. C'+t ~ ~~ .~ ,~. ~~~ ~-f ~ tyF {„ +-w- asr a~~ ;~ ,~ r J -~ ~ .-- ~- ~ .,-~ ~ ~ ~„ ~ ~~ Q ~~ ~ ~~ .~ r~ ~f ^~ ~~ J /~, ~.._t.~ ~' .~y ~`,J( ~(^ ' ~~ ~ r ~ ~((r 4 ~~ ~~ ,.a~ ~~~~~~~n~ ~ar~~ ` py~~~~~(~ _., , > ~ ~ .Z ~~ ~ ~ 1~~ G t ~!E" ~~`9 • 4 , ~ l ~~~'~ ~ f r~ ~~ f'•.[ ;~' ':': ;.::: ,..} ;...7 '•'T