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Home My WebLink About04-17-13 BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax pennsyLvania PO BOX 280601 DEPARTMENT OF REVENUE HARRISBURG PA 17128-0601 Information Notice REV-1543 11 1-M-C 1R8-12) And Taxpayer Response -24-M —t,3 - SqQ FILE NO. ACN 13118147 -08-2013 DATE 04 REC0,21L) REGIS T Type of Account Zb'3 APR 17 fid i'l i I",I I L}Estate of JAMES E RENDLER Savings SSN X Checking C L E1 K. C i Date of Death 03-21-2013 Trust JEANNETTE R BEHEL County CUMBERLAND Certificate 208 S HIGH ST ORPHANS' i MECHANICSBURG PA 17 055COWERLAIV) METRO 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.2843423746 Remit Payment and Forms to: Date Established 12-28-2012 REGISTER OF WILLS Account Balance $15,378.38 1 COURTHOUSE SQUARE Percent Taxable x 100 CARLISLE PA 17013 Amount Subject to Tax $15,378.38 Tax Rate X 0.150 NOTE*: If tax payments are made within three months of the Potential Tax Due $2,306.76 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 PARTI Step 1 : Please check the appropriate boxes below. 1 A �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 F-1 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 F-]The tax rate is incorrect. F__1 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right, and complete Part F-1 12% 1 am a sibling of the deceased. 3 on reverse.) F-1 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 N7 Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax L'�2'0 inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. I Please sign and date the back of the form when finished. PART I 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 8 112"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART T�m, CalcQ|at'CJn �--�--� If you are making m correction to the establishment data account balance(Line 2),orpercent taxable(Line 3), please obtain a written correction from the financial institution and attach ittm 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 uf the account that is taxable 0uyou. u. 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 established more than one year prior 10 the date of death,the percentage taxable ia1U0%divided by the total number of owners including the decedent. (For example:2 owners=5O%.3 owners=33.33%.4owners =25%.etoj 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. 8. 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 $ 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 ap 7. Tax Rate 7 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register ofWills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable tu"Register of Wills,AgenL^ 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 17111 axpayer 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