HomeMy WebLinkAbout02-27-13 (24)ritance Tax , Pennsylvania
BUREAU OF INDIVIDUAL TAXES PennSylVanla Inhe DEPARTMENT OF REVENUE
PO BOX 280601 Information Notice REV-1543 EX DoeEXEC (OB-12) .~
HARRISBURG PA 17128-0601 ~~~T~~ j ~J
rV{ ~~~~ FILE NQ~7~6 ~.I ~l ~ ~~~ -1
REGIST~~ ~~ ~ jj-j-S ACN 13105949
DATE 02-06-2013
~Q~3 F~.B 2?
MAE K PETERSON
1520 S MOUNTAIN RD
DILLSBURG PA 17019-8804
p€~yl
~L~~ sQ~ URA R SHOAFF
(~ ~ P ~ ~ ~ d(
~ 8 ERLAn~yoc o1-2s-2o13
Type of Account
Savings
Checking
X Trust
Certificate
rovided the department with the information below indicating that at the death of the
MEMBERS 1ST FCU p
ove-named decedent you were a joint owner or beneficiary of the account identifie .
ab
Remit Payment and Forms to:
Account No. 212725 REGISTER OF WILLS
Date Established 12-13-2010 45 NORTH GEORGE STREET
Account Balance $ 6,895.07 YORK PA 17401-1240
Percent Taxable X 50
Amount Subject to Tax $ 3,447.54
Tax Rate X 0.045 NOTE`: If tax payments are made within three months of the
Potential Tax Due $155.14 decedent's date of death, deduct a 5 percent discount on the tax
° Discount Tax x 0.95) $ (see NOTE'`) due. Any inheritance tax due will become delinquent nine months
With 5 /° ( after the date of death.
PART
1
Step 1: Please check the appropriate boxes below.
A ~ No tax ~s due.
g The information is
correct.
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.
x rate is incorrect. 4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased.
C ~ The to ^
(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).
Chan es or deductions The information above is incorrect as /a r ao rate on the back of th s forlm.
D g Complete Part 2 and part 3 pP P
listed.
E Asset will be reported on
inheritance tax form
REV-1500.
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.
~W
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 a
B. You paid the debts after the death of the decedent and can furnish proof of paymenpt if requested by the de artmen .
(If additional space is required, you may attach 8 1 /2" x 11 "sheets of paper.) p t
please obtain a written correct on from thelfinanc al~institut on~a d attach t to thi (Line 2), or percent taxable (Line 3),
1. Enter the date the account was established or titled as it existed at the date of death. s form.
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% divi
by the total number of owners including the decedent. (For example: 2owners = 50%, 3 owners = 33.33%, 4 ownedrs
= 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 t~ the riararlcn+
--- -~ ..• ••~•••,~.,~~. pan laic, ~lea5@ SIate
your relationship to the decedent: Ut>=iCial USe Only (3 AAF
1. Date Established 1 PA department of .Revenue
2. Account Balance 2 $ PAfl
3. Percent Taxable g X
4. Amount Subject to Tax 4 $ ~
5. Debts and Deductions 5 - 3
6. Amount Taxable ~
6 $ 5
7. Tax Rate ~ X ~
8. Tax Due 8 $ 7
9. With 5% Discount (Tax x .95) 9 X
Step 2: Sign and date below. Return TWO com leted an
along with a check for any payment you are making. Checks musgbe made payable toe' Ree'ste of IWill ted on the front of this form,
payment directly to the Department of Revenue. g s, Agent." Do not send
Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the be
belief. st of my knowledge and
Work
~~ ~ ~ L~~tv Home 1 7 - ~~~ ~. - J v iv ~- .
Taxpayer Signature ~ ~ '~~`~ 3
Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT YORK COUNTY RE
DEPARTMENT OF REVENUE DISTRICT OFFICE, LISTER 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 PavPP