HomeMy WebLinkAbout12-04-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
HERWIG EDWARD E
805 MOUNTAIN VIEW ST
HARRISBURG, PA 17112
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REMARKS:
SEAL
CHECK#5360
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
INITIALS: HEA
RECEIVED BY:
REGISTER OF WILLS
REV-1162 E%(11-96I
NO. CD 016873
AMOUNT
S 32.60
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INUIVIOUAL TAXES
Po Box zeosBl
HARRISBURG PA 11128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
Pennsylvania
DEPARTMENT OF REVENUE
vEV-uaa Ex oe~ex,c ,oe-,z,
FILE NO. 2170
ACN 12164530
DATE 11-26-2012
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iG~~ DEC y ~i s t ARAH C HERWIG
"4q~ate of Death 05-22-2012
EDWARD F HERWIG CLERK OGhountyCUMBERLAND
805 MOUNTAIN VIEW ST ORPHANS' COURT
HARRISBURG PA 17112-2240 GUb4g.ERLAND CC., PA
Type of Account
Savings
Checking
Trust
Certificate
PNC BANK NA provided the department with the information below indicating that at the death of the
ahnve-named decedent you were a joint owner or beneficiary of the account identified.
Remit Payment and Forms to:
Account No. 5140028542
Date Established 12-01-1964 REGISTER OF WILLS
1 COURTHOUSE SQUARE
Account Balance $ 4,347.00 CARLISLE PA 17013
Percent Taxable X 16.667
Amount Subject to Tax $ 724.51
Tax Rate X 0.045 NOTE': If tax payments are made within three months of the
Potential Tax Due $ 32.60 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 Taz 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
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 81/2" x 11"sheets of paper.)
Date Paid Payee ~°,,,;,,r;,,,,
----• •~°-• • Hmount laid
Total Enter on Line 5 of Tax Calculation $
PART Tax Calculation
•• ,-- ~•~ •••~~•••y a w. racoon ro the establishment date (Line 1) account balance (Line 2), or percent taxable (Line 3),
please obtain a written correction from the financial instttutton and attach it to this form.
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.
your relationship to the deco
1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
5 -
Debts and Deductions
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 no[ 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
Work
Home 7/7- .K~i~ -
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
ONLY: 1-800-447-3020
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