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Home My WebLink About03-26-13 BUREAU OF INDIVIDUAL TAXES Penns lvania Inheritance Tax ennsVLvania PO BOX 280601 y ✓ HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REV-1543 EX D-EXEC (08-12) And Taxpayer Response FILE N0.2113-0204 E I} ' ' r's ; l' ACN 13111847 I<: °, DATE 03-11-2013 ...!iJ L :: Type of Account 1, Estate of LORENZO W ANDERSON Savings C L E��t\ {-' SSN X Checking Trust FRED E ANDERSR ORPHANS' CountyCUMBERLAND13 Certificate 1087 N RIVER MBERLAt HALIFAX PA 17032-9425 ORRSTOWN BANK 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.410659 Remit Payment and Forms to: Date Established 06-05-1996 REGISTER OF WILLS Account Balance $19,647,98 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $9,823.99 Tax Rate X 0.045 Potential Tax Due $442.08 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. 1 A F-]No tax is due. 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. B El The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C n The tax rate is incorrect. F—] 4.5% 1 am a lineal beneficiary(parent,child, grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part F—] 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D F�Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E ❑> Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. �Q' PART Debts � F��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\n required,you may attach 81/2^x11^sheets ufpaper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART 7-ax Calculation L—��--� If you are making m 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 nf the account that ia taxable 0oyou. o. First,determine the percentage owned by the decedent. L Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii For established more than one year prior to the date uf death,the percentage taxable in100%divided by the total number nf owners including the decedent. (For example:2 owners~5O%. 3 owners=3333%.4owners ~25%.etr.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject 0o tax io determined bymultiplying the account balance by the percent taxable. 5. Enter the total cf any debts and deductions claimed from Part 2. G. The amount taxable is determined by subtracting the debts and deductions from the amount subject 1otax. 7. Enter the appropriate tax rate from Step 1 based on your relationship 0o the decedent. If indicating a different tax rate, please state your relationship to the decedent: 2. Account Balance 2 $ M 111 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 mm I 6. Amount Taxable 6 $ 0, 7. Tax Rate 7 X Step 2: Sign and date below. Return TWO completed andoignndoo i to the Register of Wills listed on the front of this form, along with m check for any payment you are making. Checks must bo made payable to"Register of Wills,AgenC^ Do not send payment directly to the Department ofRevenue. 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 Home 7/ Taxpayer Signature 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 ETZWEILER AND ASSOCIATES ATTORNEYS-AT-LAW 105 NORTH FRONT STREET HARRISBURG, PA 17101-1436 Office hours:Mon.-FA 8:00 a.m.-5:00 p.m. (717)234-5600 Earl Richard Etzweiler,Esquire ----- Christian S.Daghir,Esquire HALIFAX LINE (717)896-3737 225 Market Street Fax Line:(717)234-5610 2 West Main Street Millersburg,PA 17061 Email Address:retzweiler(&comcast.net Elizabethville,PA 17023 (717)692-2519 (717)362-8395 Office hours:Tues.and Fri.4:00 p.m.-8:00 p.m. Office hours:Thurs. 7:00 p.m.-9:00 p.m. Sat 10:00 a.m.-12:00 noon March 25, 2013 Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Room 102 Carlisle, PA 17013 Re: Estate of Lorenzo W. Anderson Dear Sir or Madam: Enclosed herewith please find three (3) of the Pennsylvania Inheritance Tax Information Notice and Taxpayer Response in reference to the above-captioned estate. Please return a time-stamped copy to me in the self-addressed, stamped envelope enclosed herein. Should you have any questions or concerns in this matter, kindly contact my office. Sincerely yours, L ' Earl Richard Etzweiler ERE:bac Enclosures H:\ESTATE-DIt\ESTATE1And--LO,.m\i —.wpd : 3 M UO !' ^ Gp Lul co el 1 - v� QQOC� e o O cn U cis 0 0 a rn O -: UP U o I'd o cn LT-4 w ° x _ .