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HomeMy WebLinkAbout12-18-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EXI11-96) BUREAU of INDiwouAL raxes DEPr. zeosoi HARRISBURG, PA 1 ] 126-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 016934 CLINE JANEL K 39 CHELSEA LN CARLISLE, PA 17015 ACN ASSESSMENT AMOUNT CONTROL ______ ,a,d NUMBER TOTAL AMOUNT PAID: REMARKS: CHECK~t9144 SEAL INITIALS: HEA RECEIVED BY: REGISTER OF WILLS 51,595.94 GLENDA EARNER STRASBAUGH REGISTER OF WILLS BUREAU OF INDIVIDUAL TAxES rD BDX 280601 Pennsylvania Inheritance Tax HARRISBURG Pq 17128-0601 Information Notice And Taxpayer Response REGISTER OF ~31LLS ~ Pennsylvania DEPAgTMENT OF gEVENUE REV-ISfI EY OatEYEC IOB~12) FILE NO. 2170 ACN 12163690 DATE 11-21-2012 ~~'~'~ ~F~ I8 P~ l~e of GLENN L CLINE S 39CCHELSEAILN CLERK Oi CDountyCUMBERLANDI2 CARLISLE PA 17015-7911 ORPHANS' COURT CUMBERLAND CO„ pA oil ' 1a - I ~ SZ-{ Type of Account Savings Checking X Trust Certificate MEMBERMEMBER-CU 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. 385428 Date Established 12.16-2011 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due With 5% Discount (Tax x 0.95) PART 1 $ 5,497.90 X 100 $ 5,497.90 X 0.045 $ 247.41 $ (see NOTE') * 235 04. 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. Sf@p 1: Please check the appropriate 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 Tar 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. i ~ 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 /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. 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 81/2" x 11"sheets of paper.) Amnunt Pald PART 3 1. 2. 3. 4. 5. 6. 7. Tax Calculation please ob ein anwr tten correction f om the fine cleld'~natRution and attach~it to this form.)' or percent taxable (Line 3), Enter the date the account was established or titled as it existed at the date of death. Enter the total balance of the account including any interest accrued at the date of death. Enter the percentage of the account that is taxable to you. a. First, determine the percentage owned by [he decedent. i. Accounts that are held "in trust for' another or others were 100% owned by the decedent. ii. byrthe totalcnumbersof olwners ncluding the decedent r(Forhexamplef 2eowne se p50%n3 ownersbi 33.33°%/4 ownedrs = 25%, etc.) b. Next, divide the decedent's percentage owned by the number of surviving owners or beneficiaries. The amount subject to tax is determined by multiplying the account balance by the percent taxable. Enter the total of any debts and deductions claimed from Part 2. The amount taxable is determined by subt based on oub re ationship tto thefde edenamount subject to tax. Enter the appropriate tax rate from Step Y your relationship to the deceoenr: 1. Date Established 1 - 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Deb[s and Deductions 5 - 6. Amount Taxable g $ 7. Tax Rate ~ X g Tax Due g $ g. With 5% Discount (Tax x .95) 9 x asjong~wit2 a check for any paymenty otu are~ma ng. Che ks mus9be made payable toe9Reg ster ofIWillseAgeMhe Do not sendorm, 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 ,, .. _ l /~i,: u„rt,P ~! 7 ' ~i~b - X34 ~ ~ ~1 //at~ Telephone Number Date txpayer Signature POARTMENTF OF REVENUIET D STRICTONOFF CEU OR RTHED NOHERITANCE I TAX D V SIION AT 7.787.8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS JLY:1-800-447-3020 BUREAU OF INDIVIDUAL TAXES PD BOX 280601 HARRISBURG PA 1]128-0601 Pennsylvania Inheritance Tax Information Notice And Taxpayer Response ~ Pennsylvania DEPARTMENT OF REVENUE acv-ssaa cz oo~exsc <oe-~z~ FILE NO.217p ACN 12163691 DATE 11-21-2012 RECORj)~D pFF1CE OF REGISTER OF ~rar' Type of Account " ° °- L~tate of GLENN L CLINE «'i1 L'EC 18 P ssN 2os-26-sass ~ Savings ALAN B CLINE (~12ofDea[h11-09-2012 Checking CARLISLEEPAL17015-7911 C my CUMBERLAND X Trust IERK Dr-' Certificate ORPHANS'CCURT ~~~iBERLAND Cp.x PA MEMBER-FCO 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. 385428 Remit Payment and Forms to: Date Established 12.16-2011 Account Balance REGISTER OF WILLS Percent Taxable $ 63,668.03 1 COURTHOUSE SQUARE X 50 CARLISLE PA 17013 Amount Subject to Tax Tax Rate $ 31,634.02 Potential Tax Due X 0.045 $ 1,432.53 NOTE": If tax payments are made within three months of the With 5% Discount (Tax x 0.95) $ (see NOTE") I '3~ 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 a p ppro riate boxes below, A ~ No tax is due. 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 Tar Due. B ©The information is The above information is correct, no deductions are being taken, and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C ^The tax rate is incorrect. ~l 4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. (Select correct tax rate at [ J right, and complete Part 3 on reverse.) ^ 12% I am a sibling of the deceased. ^ 15°~ All other relationships (including none) p ~ Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back olthis /orm. E ~ Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. 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 [he following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debt(If add tional space iseequireed, you may attach 8 P/2' zof p sheets ofrpapes) d by the department. Amount Paid g. With 5% Discount (Tax x .95) 9 X aS,jongnwit2 a check for any paymenty otu areTmaOk ng. Checks mus9bedmade payab a toe9Register ofIWillseAge the Donnot selndorm, 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 lJ~t~ t r.3a. tz Home -r1Z '~~ 5o3`F Telephone Number Date Ta,rnaver Signature ~~,.,~Tr=o nc wu I S. PA YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND GUUrv I r nr=~a~.~ ~ ~-~ ~ ~-• - • ~--- :PARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 7.787.8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ~~v.i_ann_ad7-3020 _rn _. ~ - ~~: it ~~ r:~ t s.: t 4 1-i !~ ~ N ~; J Q M ~ _ J 7 O G „ ~ ~ ~ ;,_ r :+. 1 ~ it ~(~'~ "C? ~ Q.. - O (L Y ,O ~ F~~~ `i. ~ O N o_ cn - * U W U O ,J ~ J ~ ~ ~U v I. I. ~~ ti ~. :~ i~ T ;r} i i~ ~i t