Loading...
HomeMy WebLinkAbout03-07-13 (3)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: _. _ _ _ 'J 9 REV-1162 EX~11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017287 KOONSE RICHARD D JR 710 MOORE RD WASHINGTON, PA 15301 ESTATE INFORMATION: FILE NUMBER: 2113-0273 DECEDENT NAME: KOONSE DOROTHY J DATE OF PAYMENT: 03/07/2013 POSTMARK DATE: 03/06/2013 COUNTY: CUMBERLAND DATE OF DEATH: 12/16/2012 ACN ASSESSMENT CONTROL NUMBER AMOUNT 13100625 ~ S 129.72 TOTAL AMOUNT PAID: S 129.72 REMARKS: CHECK#1941 INITIALS: HEA SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 288601 HARRISBURG PA 1]128-8601 Pennsylvania Inheritance Tax Information Notice And Taxpayer Response pennsylvania „ T OEPAPTMENT OF REVENUE NEY-ISi] E% 4a[E%EL lOE~12) FILE NO. 2170 ACN 13100625 DATE 01-04-2013 DANIEL KOONSE 710 MOORE RD WASHINGTON PA 15301-8042 CITIZENS BANK OF PENNSYLVANIA provided the dt the death of the above-named decedent you were a Account No. 6143884234 Date Established 04.25-1995 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due With 5°/, Discount (Tax x 0.95) Type of Account Estate of DOROTHY J KOON~ -~ avings w hecking Date of Death 12-16-2012 3: ~ ~ rust County CUMBERLAND 00 -o ~ _ ~ ~ ~ ertificate a ~ ^-1 ` ~' D ~ ~ -~.7 rn m .:o Cu Z CS c7 I-~ ~. ch ' ~ ~ N r1 P~ r D ~ ~ ~ W ~ Went with the information below indicating that at owner or beneficiary of the account identified. Remit Payment and Forms to: REGISTER OF WILLS $ 3,641.44 1 COURTHOUSE SOUARE CARLISLE PA 17013 X 25 $ 910 36 . X 0.150 h " NOTE : If tax payments are made within three months of t e $136.55 .~ .., ' ~ decedent's date of death, deduct a 5 percent discount on the tax $ (see NOTE' ) la- l 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 lax 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 z 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.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If ou are makin a correction to the establishment date Line 1 account balance (Line 2 , or Y 9 ( ) ) 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 [he 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%, eta) 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. It indicating a different your relationship to the 1. Date Established 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 I~~_ ~ work ''I,~F" t704'S' (03~ ¢ Home ~~~-~- 5r~~? Taxpayer Signature ~ ~ Telephone Number Date o, -~_(3 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: i-800-447-3020 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.