The URL can be used to link to this page

Home My WebLink About02-13-13BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 Pennsylvania Inheritance Tax Information Notice And Taxpayer Response PATRICK J KLEIN PO BOX 94 MILDRED PA 18b32-0094 ~ Pennsylvania DEPARTMENT OF REVENUE REV-1543 EX DocEXEC <08-12) FILE NO. g#~6- Z ("(~ - d I (~, ACN 13104879 DATE 01-31-2013 Estate of PHILOMENA T KLEIN Date of Death 12-18-2012 County CUMBERLAND Type of Account Savings Checking Trust Certificate ~ ~ ~ ~~ ..... {~ W ~ L'3 N r+++ `~ ~' 1 CITIZENS & NORTHERN aK provided the department with the information t'I~ indic~l death of the above-named decedent ou wer i wr 4 A g t~ t~pt the y e a jo nt owner or beneficiary o~,tfi~ acco identd. Account No. 41430059 Date Established 08-19-1993 Account Balance Percent Taxable $ 11,315.22 X 16.667 Remit Payment and Forms to: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 Amount Subject to Tax $ 1,885.91 Tax Rate X 0.150 Potential Tax Due $ 282.89 NOTE": If tax payments are made within three months of the With 5% Discount (Tax x 0.95) $ (see NOTE*) 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. 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 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. h~ 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 insufffci antr~te paf requested bYleneedmepartment. B. You paid the debts after the death of the decedent and can furnish proof o p y (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 ou are making a correction to the establishment date (Line 1) ac aotua h ~ I#o this form. )' or percent taxable (Line 3), Y please obtain a written correction #rom the financial institution an 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 datelef 2 owne se p50%n3 ownersbl 33.33°%/4 owners by the total number of owners including the decedent. (For examp = 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 d h u to thefdecedent mount subject to tax. ~ntar the annrouriate tax rate from Step 1 based on your relations p If indicating a different tax rate, please state your relationship to the decedent: 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 ~ X 8. Tax Due 8 ~ ., ~nr~~, ~o~ r1;c~•ni mt lTax x _951 9 X Official Use Only L7 AA1= PA Department of Revenue PAD 1 2 3 4 5 ~6 l8 a. .. ~~~ ~ ... ,., ...---- - Ste 2: Sign and date below. Return TWO completed and signed copies to thle toe'gRee stet ofIWillseAgent'e Do not sendorm, alongnwith a check for any payment you are making. Checks must be made payab g payment directly to the Department of Revenue. enalt of er'ury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and Unc~r p y p J be ref. Work Home ~~ /C~~" Y; ~-~^`~"' Date Taxpayer S nature Telephone Number D FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER p V SIION ~ AT IF YOU NEE OR THE INHERITANCE TAX DEPARTMENT OF REVENUE DISTRICT OFFICE, - SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS 717-787 8327. ONLY: 1-800-447-3020 n,,.....~r,+;,,,, Amount Paid r a ~ N Od ~ yy~e5a80 d p ZL:ZL ~ ~ r ~A3~~ ~'i rl oQ$~ ~i ~~~ ~, $' w !!J ,...1 ~~ ~ ~ ~ ~ ~ ~ ~. ~' ~ ~ ~..~ r'~ef- c"a w 7~1~ ~ ~ ) ~.y.y,.~~ ~ ',~ ~./~ ay,. ~_ . t Lid i! ~ ~'rs 'r.T C=:3 !~,,,~ F,....~ ~Z SJ {~ ~'F,3 !~j ~~} .a..} j ~'} ~''•.. :»t