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HomeMy WebLinkAbout02-27-13 (11)ritance Tax ~ pennsylvania BUREAU OF INDIVIDUAL TAXES PennsylVanla Inhe DEPARTMENT OF REVENUE PO BDX 280601 Information Notice REV-1543 EX DocEXEt (OB-12) HARRISBURG PA 17128-0601 ~,,'~„~J -~ And Taxpayer Response FILE NO. s~e~-~ // - - ACN 13105938 DATE 02-06-2013 REGISTER OI` 1~1-S ?~i3 FEO 2? Phi ~ 07 RICHARD H SHOAFF CLERK 0~ PO BOX 117 ~O~S' (i{~~~T NEW KINGSTOWN PA 17~'rO~~IBEI~L~I~D ~~.' ~~ Estate of LAURA R SHOAFF SSN Date of Death 01-28-2013 County YORK 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 06-02-2011 45 NORTH GEORGE STREET Account Balance $13,793.73 YORK PA 17401-1240 Percent Taxable X 50 Amount Subject to Tax $ 6,896.87 Tax Rate X 0.045 NOTE'`: If tax payments are made within three months of the Potential Tax Due $ 310.36 decedent's hatetance taxi due will become delinquent n ne meonths With 5% Discount (Tax x 0.95) $ (see NOTE'`) due. Any in e after the date of death. PART Step 1: Please check the appropriate boxes below. 1 e, I am the spouse of the deceased or I am the parent of a decedent who was A ~ No tax is du 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 information is The above information is correct, no deductions are being taken, and payment will be sent B with my response. correct. 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. C ~ The tax rate is incorrect. (Select correct tax rate at right, and complete Part ~ 12% I am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). Changes or deductions The information above is incorrec3 as /a r ao r aae on the back of this form. D ~ listed. Complete Part 2 and part pP P r orted on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax E 1~ Asset will be ep inheritance tax form Returnoceed to Step 2 onPeverseatlDo not check any other boxes. REV-1500. he form when finished. Please sign and date the back of t 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~+~.,., ,a:u____~ -~•••.y ~ Y~~~~~~~~< <a~ ~dlC, Pease 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 ~ X 8. Tax Due 8 $ 9. With 5% Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Re is r along with a check for any payment you are making. Checks must be made payable to ' Registe of IWiIIseA e t 'e Do notf this form, payment directly to the Department of Revenue. 9 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 I PAD. !i 2 3 4 5 6 7 8 Official. Use Only ^ ~~ PA Department of Revenue ,~~, / ~' ~ ~' ~.~ Work Taxpayer Signature Home ~~ ~v' 4 ~ ~ Z ~~ "~ Telephone Number to !IF YOU NEED FURTHER ASSISTANCE, CONTACT YORK COUNTY REGIST DEPARTMENT OF REVENUE DISTRICT OFFICE, ER OF WILLS, PA 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEAR ERITANCE TAX DIVISION AT ONLY. 1-800-447-3020 ING AND/OR SPEAKING NEEDS Date Paid PavPP ~ ..