HomeMy WebLinkAbout04-08-13 (3) COMMONWEALTH OF PENNSYLVANIA REV-1162 EX{11 961
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL i'AXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 017413
�I
RONAN LYNN A
759 PETERSBURG RD
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---------
13107366 j $12.45
ESTATE INFORMATION: SSN: f
FILE NUMBER: 2113-0393
DECEDENT NAME: RONAN WILLIAM R
DATE OF PAYMENT: 04/0$/2013
POSTMARK DATE: 04/05/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2013
TOTAL AMOUNT PAID: $12.45
REMARKS:
CHECK# 515
INITIALS: HEA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
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BUREAU of IHS1vInunl TAXES Pennsylvania Inheritance Tax Pennsylvania
PO BOX 280601 ■ill\�! DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0 6 01 Information expo eev.�e<s cx 0..xM tee-z,
And Taxpayer Response E1t.E Wi}£W70 all
ACN 13107366
DATE 02-14-2013
i
Type of Account
Estate of WILLIAM R RONAN Savings
Checking
Date of Death 02-03-2013 Trust
LYNN A RONAN County CUMBERLAND Certificate
729 PETERSBURG RD
CARLISLE PA 17015-9231
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MEMBERS IST Feu provided the department with the information below indicate g la at the deaihV the
above-named decedent you were a joint owner or be ficlary of the account idept' ' ° -_n
Remit Payment and Forms Un r m
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Account No.442377 cv r
Date Established 12-06-2011 REGISTER OF WILLS -o tv cn �q
Account Balance $3,493.60 1 COURTHOUSE SQUARE a co
Percent Taxable X 8.333 CARLISLE PA 17013
Amount Subject to Tax $291.12
Tax Rate X 0.045 NOTE`; If tax payments are made within three months of the
Potential Tax Due $ 13.10 decedent's date of death, deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE') 12,.cy due. Any inheritance tax due will become delinquent nine months
after the date of death.
ffStep 1: Please check the appropriate boxes below.
A [-]No taxis 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 Fax Due.
g The information is The above information is correct,no deductions are being taken,and payment will be sent
oorrect. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C The tax rate is incorrect. 4.5% 1 am a lineal beneficiary (parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right, and complete Part 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.
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 8112"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
y 9 ( ) ( ), 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"intrust 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 10001*divided
by the total number of owners including the decedent. (For example:2 owners=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
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 6 $
7. Tax Rate 7 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 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
LC� —Home
T ayer 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: 1-800-447-3420