HomeMy WebLinkAbout01-17-13BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
h OE' .';';'_LS
.'.013 JAN 17 Pj~ 12 ly
FANELLI LISA CL~~°,K n'
94 VAN HOUTON AVE ORPHANS' CV~R
CHATHAM NJ o79za-IZ2IOUMBERLAND GQ., Pq
~ Pennsylvania
DEPARTMENT OF REVENUE
xevasasa cx oo~exee ,oaaz~
FILE NO. 2112-1242
ACN 13500016
DATE 01-03-2013
Estate of PEARL REGISTER
SSN 203-20-4722
Date of Death 06-23-2012
County CUMBERLAND
Type of Account
Savings
Checking
Trust
Certificate
ANERIPRISE FINANCIAL 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. 19307099
Date Established
Account Balance $ 332,403.64
Percent Taxable X 33.333
Amount Subject to Tax $ 110,800.11
Tax Rate X 0.045
Potential Tax Due $ 4,986.00
With 5% Discount (Tax x 0.95) $ (see NOTE`)
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 a 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 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 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.)
PART
3
1.
2.
3.
4.
5.
6.
7.
Tax Calculation
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.
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 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.
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 subtracting the debts and deductions from the amount subject to tax.
Enter the appropriate tax rate from Step t based on your relationship to [he decedent.
If indicating a different tax ra
you r relationship to the dece
1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
9
5
rnr~ti s°i nisnnunt ITax x .951 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 `l~3-~ti(-0513 ~~t3 ~l~
Telephone Number
Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF W1LLS, 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
Taxpayer Signature
„_,,,,,;,,,;,,,, Amount Paid
BUREAU OF INOIVIUUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
'i~3 J~?N 17 P(~ 12
FANELLI LISA R CLE~-iC ~.;;-
94 VAN HOUTON AVE ORPHAtaS' rrJURT
CHATHAM NJ o79za-I22ICUMBERLA~®d~ r.rj„ pA
Type of Account
Savings
Checking
Trust
Certificate
AMERIPRISE FINANCIAL 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. 55583348
Date Established
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
With 5°/, Discount (Tax x 0.95)
PART
1
$ 229,222.14
X 33.333
$ 76,406.62
X 0.045
$ 3,438.30
$ (see NOTE')
~ Pennsylvania
DEPARTMENT OF REVENUE
xev-~uee Ex m~ezcc ,Dean
FILE NO. 2112-1242
ACN 13500019
DATE 01-03-2013
1 y Estate of PEARL REGISTER
SSN 203-20-4722
Date of Death 06-23-2012
County CUMBERLAND
Remit Payment and Forms to:
REGISTER OF WILLS
1000RTHOUSESOUARE
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 [ax due will become delinquent nine months
after the date of death.
Step 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 p~ l Asset will be reported on
lllF"'--~~-~~ 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 o/this /orm.
1-he above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
3eturn 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.
,;p•a,
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 81/2" x 11"sheets of paper.)
n..,..,,nt Pohl
PART
3
1.
2.
3.
4.
5.
6.
7.
Tax Calculation
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.
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 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 beneficlarles.
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 subtracting the debts and deductions from the amount subject to tax.
Enter the appropriate tax rate.from Step 1 based on your relationship to [he decedent.
Amount Subject to Tax
-~(ai - US 13
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
Taxpayer Signature
aslong~wit?a chleck for any pay entyotu are maOk ng. Che ks mus9be madeepayable toegReg s~er olflWilSSeAgent e Donnot 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 ~
PDRBOX 28060DIVIDUAL TAXES Pennsylvania Inheritance Tax
HARRISBURG PA 17128-0601
Information Notice
And Taxpayer Response
°" il`J~
RECiS ~ ~ ; ar :;:.~s
~ Pennsylvania
DEPARTMENT OF REVENUE
aev-maan zx m~exzo coo-~a
FILE NO. 2112-1242
ACN 13500022
DATE 01-03-2013
`~V3 ~Fl1j ~ 7 P( I ~ ~9tate of PEARL REGISTER
N 203-20-4722
FANELLI LISA R CLERi{ C4" Date of Death 06-23-2012
94 VAN HOUTON AVE ORPHANS' ~~~u°T County CUMBERLAND
CHATHAM NJ 07928-1221
CUMBERLANE i~;,~„ PA
Type of Account
Savings
Checking
Trust
Certificate
AMERIPRISE FINANCIAL 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. 279155378021
Date Established
Account Balance $ 79,000.00
Percent Taxable X 33.333
Amoun[ Subject to Tax $ 26,333.07
Tax Rate X 0.045
Potential Tax Due $ 1,184.99
With 5% Discount (Tax x 0.95) $ (see NOTE`)
Remit Payment and Forms to:
REGISTER OF WILLS
1000RTHOUSESOUARE
CARLISLE PA 17013
NOTE': If tax payments are made within three months of the
duee Any nherrtance tax due will become delnlquent n netmonths
after the date of death.
PART Step 1: Please check the a p
1 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 appropdate on the back o/this form.
The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
aeturn 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 81/2" x 11"sheets of paper.)
PART
3
1.
2.
3.
4.
5.
6.
7.
Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my now e g
belief.
Work /
--~ D ~ _ U 0 : Home Q 73'7vf -bSl3 `l (~Il'~
Tax Calculation
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.
Enter the date the account was established or titled as it existed at [he 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 the decedent.
i. Accounts that are held "in trust for" another or others were 100% owned by the decedent.
ii. byrthe total numbersof owners nclud ng the decedenrL r(Forhexamplef 2 owne se P50%n3 ownersbl 33.33 ~ /4 owners
= 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 subtracting the debts and deductions from the amount subject to tax.
Enter the appropriate tax rate from Step t based on your relationship to the decedent.
Step, 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this Corm,
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.
k I d e and
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
Taxpayer Signature
,,,,,,,,,;,,,;,,,, Amount Paid
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