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Home My WebLink About11-07-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%ES DEPT. 260fi01 HARRISBURG, PA 1 ] 128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BOYD HURSHAL E 899 OAK OVAL MECHANICSBURG, PA 17055 Baia ESTATE INFORMATION: ssnl: eta-is-ztz5 FILE NUMBER: 2112-1175 DECEDENT NAME: BOYD ROSANN DATE OF PAYMENT: 11/07/2012 POSTMARK DATE: 1 1 /06/201 2 COUNTY: CUMBERLAND DATE OF DEATH: 07/10/2011 12158858 ~ 5105.84 REV-1162 EX111-961 NO. CD 016743 AMOUNT ACN ASSESSMENT CONTROL NUMBER TOTAL AMOUNT PAID: REMARKS: S 105.84 CHECK#1480 INITIALS: HEA SEAL RECEIVED BY: GLENDA =ARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES 4\~ ,I~nnsylvania Inheritance Tax PD Box zaosol , ,.., \~y Information Notice HARRISBURG PA 1]128-0601 r~C%~ ~,tFG~I~c, ~ ~ ~'~~"~ And Taxpayer Response ~1.i~` `" GUM~~`~D ~~..PP ~ Pennsylvania DEPARTMENT OF REVENUE xEV-~sas Ex ue=cxc< <oe-~z~ FILE NO. 2170 ACIV 12158858 DA'iE 10-26-2012 Estate of ROSANN BOYD Date of Death 07-10-2011 County CUMBERLAND JONATHAN M BOYD 899 OAK OVAL MECHANICSBURG PA 17055-8409 Type of Account Savings Checking X Trust Certificate PNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No. 31500290762 Date Established 05-09-2006 Account Balance Percent Taxable Amount Subject to Tax Remit Payment and Forms to: REGISTER OF WILLS $ 2,352.00 1 COURTHOUSE SQUARE CARLISLE PA 17013 X 100 _ $ 2,352.00 Tax Rate X 0.045 Potential Tax Due $105.84 With 5% Discount (Tax x 0.95) $ (see NOTE') NOTE': If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax 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 dThe 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 ary 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. PART z 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.) Date Paid Payee nPC!`rinrinn PART 3 ---- nns~ If ~ _~.~_ Total (Enter on Line 5 of Tax Calculation $ TaX Ca~CUiatlOn •• ,-- -•~ ••.o..,.,y a canecuvn >o me eswousnment sate (Line 1) account balance (Line 2), or percent taxable (Line 3), please obtain a written corrgctlon from the financial institution and attach It to this form. 1. Enter the date the account was established or titled as it existed at [he 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: 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 g $ 7. Tax Rate 7 X 8. Tax Due g $ 9. With 5% Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to "Register of Wills, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. Taxpayer Signature P(J Work Home Telephone Number Date ~/ IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS DNLY: 1-800-447-3020 0 ;1 fh 1 e:. ;,$ '~ `.r '•~ ~1 e' N. ~S a , x . s < <, ~: ; _u ~_i s ~_ Ll li+ ~< '- - r ~ ~ cl _p ~ c'-, ~`~ ~.1. . 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