HomeMy WebLinkAbout02-28-13COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 017248
BENJAMIN JEFFREY H
435 WEST SOUTH STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION:
FILE NUMBER: 211 1-0875
DECEDENT NAME: HAMMEL SUSAN- RIDGWAY
DATE OF PAYMENT: 02/ 28/ 2013
POSTMARK DATE: 02/28/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 08/08/201 1
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
13107263 ~ $5.41
13107264 ~ $94.83
13107265 ~ $140.56
TOTAL AMOUNT PAID:
5240.80
CHECK# 3517
INITIALS: HMW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax
PO BOX 280601
HARRISBURG PA 17128-0601 Information Notice
And Taxpayer. Response
~F~ ~~~~ ~~~j~~ ~~
~ Pennsylvania
DEPARTMENT OF REVENUE
REV-1543 EX DocEXEL (08-12)
FILE N0..2iZ~9-,ZI- ~j "~~~~
ACN 13107263
DATE 02-14-2013
---w.~ ~ ~n yr ~~fL~.S
~~13 FfB 28 F~
~~ate of SUSAN R HAMMEL
~ L ~ ~ K ~ ~
ORPHA~~ ~~~~~ Date of Death os-os-2011
BRIN H BENJAMIN ~ County CUMBERLAND
435 W SOUTH ST ~~~f $f RLAN~ gip,, PA
CARLISLE PA 17013-2829
Type of Account
Savings
Checking
Trust
Certificate
CORNERSTONE Fcu 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. 453001
Date Established 03-23-1994
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
With 5% Discount (Tax x 0.95)
Remit Payment and Forms to:
REGISTER OF WILLS
$ 240.44 1 COURTHOUSE SQUARE
CARLISLE PA 17013
X 50
$ 120.22
X 0.045
$ 5.41
$ (see NOTE*)
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.
P ;RT Step 1: Please check the appropriate boxes below.
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
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 8 1/2" x 11"sheets of paper.)
PART Tax Calculation
3 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.
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 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 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.
If indicating a different tax rate, please state Official USe Only ^ AAF
your relationship to the decedent: PA Department t3f Revenue
1. Date Established 1
2. Account Balance 2 $ PAD
3. Percent Taxable 3 X 1
2
4. Amount Subject to Tax 4 $ 3
5. Debts and Deductions 5 - 4
6. Amount Taxable 6 $ 5
7. Tax Rate 7 X fi
8. Tax Due g $ ~
8
9. With 5% Discount (Tax x .95) 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.
~, , ~ r, Work
Taxpayer Signature
v~ Home
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
Date Paid Payee Description Omni ant D~iiJ
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
~~C i
~F~
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
~ Pennsylvania
DEPARTMENT OF REVENUE
REV-1543 EX DocEXEC (08-12)
FILE NO. ~~ ,~.~' ~~ " ~~~
ACN 13107264
DATE 02-14-2013
~~~~ ~'~p ~ ~ ~
UU ,~8 G~ ~.~i
~~ ~ state of SUSAN R HAMMEL
~~~~ E~~ Q~
~ ~~~• ~~i} County CUMBERLANDII
435NWHSOUTHASTN ~~~RL'~~~ ~; ~~
CARLISLE PA 17013-2829 ~'f ~
Type of Account
Savings
Checking
Trust
X Certificate
CORNERSTONE Fcu 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. 453010
Remit Payment and Forms to:
Date Established 02-11-2000 REGISTER OF WILLS
Account Balance $ 4,214.70 1 COURTHOUSE SQUARE
CARLISLE PA 17013
Percent Taxable X 50
Amount Subject to Tax $ 2,107.35
Tax Rate X 0.045 NOTE*: If tax payments are made within three months of the
Potential Tax Due $ 94.83 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.
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% Alt 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
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 8 1 /2" x 11 "sheets of paper.)
PART Tax Calculation
3 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.
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 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 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 inaicating a aitterent 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 g $
7. Tax Rate 7 X
8. Tax Due g $
9. With 5% Discount (Tax x .95) 9 X
Official Use Only D AAF
PA Department of Revenue
PAD
1
2
3
4
5
fi
7
8
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.
~~~ ~ ~~
Taxpayer Signature
Work
Home ~` ~ - Z~
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
Date Paid Payee Descri~ti~n a r,,,,,~ ,.,+ o.,,a
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
~ ~ ~ R ~ (~ ~. Date of Death 08-08-2011
BRIN H BENJAMIN County CUMBERLAND
435 W SOUTH ST OR~H~~~~ CQU~T
CARLISLE PA 17013-2829 ~`~l~ERLAND C~., PQ
Type of Account
Savings
Checking
Trust
Certificate
CORNERSTONE Fcu 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. 453018
Remit Payment and Forms to:
Date Established 01-22-2008 REGISTER OF WILLS
Account Balance $ 6,246.93 1 COURTHOUSE SQUARE
CARLISLE PA 17013
Percent Taxable X 50
Amount Subject to Tax $ 3,123.47
Tax Rate X 0.045
Potential Tax Due $ 140.56 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.
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.
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
RE~~~T~~ OF '~'~~.LS
~ Pennsylvania
DEPARTMENT OF REVENUE
REV-1543 EX DocEXEC <08-12) ~ „/-
FILE NO:~-zz1-r~ ~ ~~ ~,
ACN 13107265
DATE 02-14-2013
~~~~ F~~ 2$ ~~ ~ ~,~tate of SUSAN R HAMMEL
S N 476-56-3934
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 Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3 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.
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 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 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.
If indicating a different tax rate, please state Official USe Only ^ AAF
your relationship to the decedent: PA Department Of .Revenue
1. Date Established 1
2. Account Balance 2 $ PAD
3
P
t T
bl X ~
.
ercen
axa
e
4
A
S 3 $ 2
.
mount
ubject to Tax 4 3
5
D
b
d D
.
e
ts an
eductions 5 - 4
6
A
T
l $ 5
.
mount
axab
e 6
7. Tax Rate 7 X 6
8
T
D $ ~
.
ax
ue
9
With 5% Di 8 X
.
scount (Tax x .95) 9
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
~~'z~~l % ~ Home t - 2 k~ - ~ ~ Z Z3 t 3
Taxpayer Signature Telephone Number Date
F 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