HomeMy WebLinkAbout11-15-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PARKINS ANN L
1 1 1 CHESTER RD
ENOLA, PA 17025
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION:
FILE NUMBER: 2112-1203
DECEDENT NAME: LOWDERMILK MARY E
DATE OF PAYMENT: 1 1 / 15/2012
POSTMARK DATE: 1 1 /14/2012
COUNTY: CUMBERLAND
DATE OF DEATH: 04/07/201 2
REV-1162 EX(11-96)
NO. CD 016788
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
12161751 ~ $10.03
TOTAL AMOUNT PAID:
REMARKS:
$10.03
CHECK# 1 106
INITIALS: HMW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES ~',~
-~- + , s vania n entance Tax
PO BOX 280601 C"[ f~f ~~ t `. ~ ' I~.J ~ Y
HARRISBURG PA 17128-0601 ;~c~ ..:j • ; ~?t ~ C Information Notice
~`~' `. - ~ `~-"end Taxpayer Response
~~
~ Pennsylvania
DEPARTMENT OF REVENUE
---~"---~~~ REV-1543 EX DocEXEC (08-12)
FILE NO. 2170 Z.1 " ~~ ~ /~~~
ACN 12161751
DATE 11-08-2012
- .;
~~~~ PA
ANN L PARKINS
111 CHESTER RD
ENOLA PA 17025-2612
Date of Death 04-07-2012
County CUMBERLAND
Type of Account
Savings
X Checking
Trust
Certificate
SOVEREIGN 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.
Remit Payment and Forms to:
Account No. 571120733
Date Established 09-01-1984 REGISTER OF WILLS
Account Balance $ 1,337.90 1 COURTHOUSE SQUARE
Percent Taxable X 16.667
CARLISLE PA 17013
Amount Subject to Tax $ 222.99
Tax Rate X 0.045
Potential Tax Due $ 10
03 NOTE*: If tax payments are made within three months of the
'
. 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.
B The information is
U correct.
C ~ The tax rate is incorrect.
(Select correct tax rate at
right, and complete Part
3 on reverse.)
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 abova ir~formaiior is correct, no deductions are tJCing taker, and paymei.t will be Sei-~t
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).
D ~ Changes or deductions
listed.
E ~ Asset will be reported on
inheritance tax form
REV-1500.
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 Debts and Deductions
2
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 Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3 If you are making a correction to the establishment date (Line 1) account balance (Line 2), or percent taxable (Line 3),
please obtain a written correction from the financial institution 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.
If indicating a different tax rate, please state OffjCial USe Only ^ AAF
your relationship to the decedent: PA Department of Revenue
1. Date Established 1
2. Account Balance 2 $ PAD
3. Percent Taxable 3 X 1
4. Amount Subject to Tax 4 $ ~
3
5. Debts and Deductions 5 - 4
6. Amount Taxable 6 $ 5
7. Tax Rate 7 X ~
o. Tax Due 8 $ 7
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.
Work ~~~ 3G~•%~ ~'
_ Home ~i7• '~3~ - //~ S
Taxpayer 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