HomeMy WebLinkAbout12-07-12BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 1]128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
~ Pennsylvania
DEPARTMENT OF REVENUE
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FILE NO. 2170
ACN 12162336
DATE 11-12-2012
BYRON R RENNER
APT 325
210 BIG SPRING RD
NEWVILLE PA 17241-9497
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ACNB BANK 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. 222216
Date Established 08-13-2003
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Estate of DORINE V RENNER
SSN 508-18-4829
Date of Death 09-14-2012'
Countv CUMBERLAND
Remit Payment and Forms to:
REGISTER OF WILLS
$ 10,231.72 1 COURTHOUSE SQUARE
X 50 CARLISLE PA 17013
$ 5,115.86
X 0.045
Potential Tax Due $ 230.21
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 Ste 1: Please check the a p
1 P ppro riate boxes below.
A ~ No tax is due.
B ~ The information is
correct.
C ~ The tax rate is incorrect.
(Select correct tax rate at
right, and complete Part
3 on reverse.)
p ~ 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.
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 81/2" x 11"sheets of paper.)
Date Paid Payee Description Hmoum raiu
Total Enter on Line 5 of Tax Calculation $
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.
Work
Signature
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