HomeMy WebLinkAbout02-27-13 (7)BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
Pennsylvania Inheritance Tax
Information Notice
And Taxpayer Response
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pennsylvania
DEPARTMENT OF REVENUE
REV-1543 EX DoeEXEC (OB-12)
FILE NO.~•7~~ ~~ -I,~."~ ~`i'°
ACN 13105942
DATE 02-06-2013
'13 FE8 ~ ~ P~ y ~ F
Estafe of LAURA R SHOAF
Date o9 Death 0$$28-2013
d~~H~~$' ~(}j~~~untyYORK
EVERETT E SHOAFF ct~BER~.Al~G ~ fl.• P~
132 SPRING RD
DILLSBURG PA 17019-9352
Type of Account
Savings
Checking
X Trust
Certificate
cu rovided the department with the information below indicating that at the death of the
MEMBERS 1ST F p
above-named decedent you were a joint owner or beneficiary of the account identifie .
Remit Payment and Forms to:
Account No. 212725 REGISTER OF WILLS
Date Established 08-04-2011 45 NORTH GEORGE STREET
Account Balance $ 5,993.95 YORK PA 17401-1240
Percent Taxable X 50
Amount Subject to Tax $ 2,996.98
Tax Rate X 0.045 NOTE*: tf tax payments are made within three months of the
Potential Tax Due $134.86 decedent's date of death, deduct a 5 percent discount on the tax
h 5% Discount (Tax x 0.95) $ (see NOTE'`) due. Any inheritance tax due will become delinquent nine months
Wit after the date of death.
PART Step 1 ;Please check the appropriate boxes below.
1
t f a decedent who was
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.
am the spouse of the dece ate of death the paren o
21 years old or younger at d
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.)
•• ~~~ a.~ ~~~a~~~~y 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 inrlir~~+~nn ., .J:fF.._.._a .
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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 $
?. Tax Rate ~ X
8. Tax Due 8 $
9. With 5% Discount (Tax x .95) 9 X
Official Use Only ~J AAF
PA Department of Revenue
f PAfl
1
2
3
4
5
7
8
5iep 1: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the fr
along with a check for any payment you are making. Checks must be made payable to "Register of Wills, A ent." Do no f this form,
payment directly to the Department of Revenue. 9 t send
Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of m kn
belief.
y owledge and
~,~~~ Work
Taxpayer Signature
Home Jj~.-Y3~ -
Telephone Number
Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT YORK COUNTY REGISTE
DEPARTMENT OF REVENUE DISTRICT OFFICE, R OF WILLS, PA
717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEA HERITANCE TAX DIVISION AT
ONLY. 1-800-447-3020 RING AND/OR SPEAKING NEEDS
Date Paid Pavee ~ ..