HomeMy WebLinkAbout02-11-13BUREAU OF INDIVIDUAL TAXES Penns Ivania Inheritance Tax
PO BOX 280601 Y
HARRISBURG PA 17128-0601 Information Notice
And Taxpayer Response
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DEPARTMENT OF REVENUE
REV-1563 EX DocEXEC (08-12)
FILE NO. 2113-0026
ACN 13106006
DATE 02-06-2013
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Estate of AGNES F GULA
SSN
Date of Death 01-04-2013
County CUMBERLAND
Type of Account
Savings
Checking
Trust
Certificate
CITIZENS BANK OF PENNSYLVANIA 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. 6212806849 Remit Payment and Forms to:
Date Established 07-05-2005 REGISTER OF WILLS
Account Balance $ 22,415.41 1 COURTHOUSE S(~UARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $ 11,207.71
Tax Rate X 0.150
Potential Tax Due
$1
681
16 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.
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.
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 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 bescription Amount Paid
Total (Enter on Line 5 of Tax Calculation) $
If YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA
pEPARTMENT 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