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Home My WebLink About12-31-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. zeosot HARRISBURG, PA 1 J128-O60t RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 016981 BREITENBACH JOSEPH M 1310 PHEASANT DRIVE S CARLISLE, PA 17013 - - ,old ESTATE INFORMATION: sSN: i95-is-9x94 FILE NUMBER: 2112-1 151 DECEDENT NAME: BREITENBACH GERALDINE P DATE OF PAYMENT: 12/31/2012 POSTMARK DATE: 1 2/31 /201 2 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2012 REMARKS: ACN ASSESSMENT CONTROL NUMBER REV-1162 EX(7 7-961 AMOUNT 12158489 ~ $122.62 12158490 ~ 5663.57 12158491 ~ 5540.73 TOTAL AMOUNT PAID: 51,326.92 CHECK#966 INITIALS: HEA sEaL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 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. Pennsylvania DEPARTMENT OF REVENUE FILE NO. 2170 ACN 12158491 DATE 10-24-2012 Type of Account JOSEPH M BREITENBACH 1310 PHEASANT DR S CARLISLE PA 17013-1229 Estate of GERALDINE P BREITENBACH SSN Date of Death 10-15-2012 County CUMBERLAND Savings Checking Trust Certificate C1 n, `_: ~ ~ ~ c m m %° ~? c? o ~'~ m ~ n c'] f19 ~3 .Tl ~, ~ [,~ _..a c-;r i 1~ Y ' ,. a> - _ . - c, :z ';;~ ..~~ F- C-= r} ' .., 'P'Y .,..r T\~ i;l ui "rt MEMBERS lsr Fcu 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. 29327 Date Established 12-17-1993 Account Balance $ 25,297.37 Percent Taxable X 50 Amount Subject to Tax $12,646.69 Tax Rate X 0.045 Potential Tax Due $ 569.19 With 5% Discount (Tax x 0.95) $ (see NOTE") Sf/0.73 Remit Payment and Forms to: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 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 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. 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. Pennsylvania Inheritance Tax Information Notice And Taxpayer Response 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. BUREAU Of INDIVIDUAL TAXES Po Box zaosol HARRISBURG PA 17128-0601 JOSEPH M BREITENBACH 1310 PHEASANT DR S CARLISLE PA 171713-1229 ~ Pennsylvania DEPARTMENT OF REVENUE aevnzae ex oooexsc ,oe-~a FILE NO. 2170 ACN 12158490 DATE 10-24-2012 Type of Account Estate of GERALDINE P BREITENBACH ~ Savings SSN Checking Date of Death 10-15-2012 Trust County CUMBERLAND Certificate t? ~ O zf ~., rte; ~' ~ M m ~, ?' R'f F~ •..{ R7 rr"r"t f .7 ,,.y ~, `tl '-~ c- ~ ~ ~~ ~"~i MEMBERS 1sT Fcu provided the department with the information below indicating that at tlie::dea`~7 o~the above-named decedent you were a joint owner or beneficiary of the account identified. Account No. 29327 Date Established 03-15-1982 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due With 5% Discount (Tax x 0.95) Remit Payment and Forms to: REGISTER OF WILLS $ 31,044.46 1 COURTHOUSE SOUARE X 50 CARLISLE PA 17013 $15,522.23 X 0.045 $ 698.50 $ (see NOTE') ~~~ 3 57 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 1 p ppropriate boxes below. 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.) p ~ Changes or deductions listed. E ~ Asset will be reported an 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 ofthis /orm. 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. Pennsylvania Inheritance Tax Information Notice And Taxpayer Response 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.) Date Paid Payee Description Amount Paid 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 Instftutlon and attach k 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 your relationship to the decedent: Sor> 1. Date Established 1 __ 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 3 X 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 $ 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 [his 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 [hat the facts I have reported above are true, correct and complete to the best of my knowledge and belief. Work Signature Telephone Number ~ ~; 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 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.) Date Paid Amoun[ Paid Pavee Description PART Tax Calculation 3 If you are making a correction to the establishrr~nt date (Line 1) account balance (Line 2), or percent taxable (Line 3), please obtain a written correction from the financial Institution and attach K 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. (Far 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 [he 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: SD.V 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 6 $ 7. Tax Rate 7 x 8. Tax Due 8 $ 9. With 5% Discount (Tax x .95) 9 x .St@p 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 Home ~ ~' .3 / 3 .?o ax ayer 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 ON LY: 1-800-447-3020 BUREAU DF INDIVIDUAL TAxES Penns Ivania Inheritance Tax ~ enns lvania PO BDX 280601 v P Y HARRISBURG PA 11128-0 6 01 Information Notice DEPARTMENT OF RE VENUE REV-1563 E[ OacE%EC IYR'1]) And Taxpayer Response FILE N0.2170 ACN 12158489 DATE 10-24-2012 Type of Account JOSEPH M BREITENBACH 1310 PHEASANT DR S CARLISLE PA 17013-1229 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. t :~ r..o r.- ^v C7 r-, n c-~ r'- I'r, FW-+ 71 ~., :-x, `_! ~,. c r\ LrI Savings Checking Trust Certificate ~ ~ rr1 Cm7 47 ~ cn ~ -.q e:::: ;'~C rl,e ~w . ~, "r, ':;? ..: ?: Gs ~) "TY MEMBERS 1sT Fcu 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. 29327 Remit Payment and Forms to: Date Established 01-28-1982 REGISTER OF WILLS Account Balance $ 5,736.53 SE S 03ARE Percent Taxable X 50 8 CARLISLE pA Amount Subject to Tax $ 2,ggg.p7 ~ Tax Rate X 0.045 Potential Tax Due $ 129.07 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')~9r/2.2 / due. Any inheritance tax due will become delinquent nine months after the date of death. PART Ste 1: Please check the a 1 P ppropriate boxes below. A ~ No tax is due. g ~ The information is '~'t' 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. 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. Estate of GERALDINE P BREITENBACH SSN 195-16-9494 Date of Death 10-15-2012 County CUMBERLAND n C O ~ ~ m ~' ~ z r- U7 C? n cy c:, :> c::: e~ 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 torm. 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 Pavee 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 "intrust 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, your relationship to the decede 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions ;ase state ~p,V 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due f3 $ 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 Home Signature Telephone Number 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