HomeMy WebLinkAbout02-0302COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171ZB-0601
REV-~i5 EX AFP cog-o0)
ZNFORMATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE NO. 21 ~:L-302_
ACN 02105861
DATE O2-Oq-ZOOZ
'02 l'iii!' 25
KIMBERLY SHELLEY
$5Z1 MARCH DR ....
CAMP HILL PA 17011 ~,L~
. TYPE OF ACCOUNT
i~'ST. OF PATRICIA SHELLEY [] SkV:XNGS
S.S. NO. ?06-57-q175 []CHECKTNG
., ~0,~]3 OF DE:A?]{ 1Z-16-ZOOI [] TRUST
i~,(C~TY CUMBERLAND [] CERTZF.
REMTT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NAY PO[NT BANK has provided the Department withtha ln~oreetion 11sted beloa which has been used in
calculating the potentiaX tax due. Their records indicate that at the death of the above decedent, you aero a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain eritten correction from the financial institution, attach a copy
to this fora and return it to the above address. This account is taxable Jn accordance with the Inheritance Tax LeNs of the Commonwealth
COMPLETE PART I BELOW # # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 50011q617Z Da~o 07-02-199Z
Established
Accoun~ Balance 1,021.50
Porcen* Taxable X 50.000
Aeoun~ Subjec~ ~o Tax 510.75
Tax Ra~o X .15
Po~an~ial Tax Oua 76.61
To insure proper credit to your account, two
(2) copies of this notice ~ust accompany your
payment to the Register of #ills. Make check
payable to: "Register of Wills, Agent".
NOTE: If tax payments are made within three
(3) months of the dacedent's date of death,
you amy deduct a sg discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
A. [] The above information and tax due is correct.
1. You may choose to remit payment to the Register of Rills eith tho copies of this notice to obtain
CHECK a discount or avoid interest, or you amy check box "A" and return this notice to the Register of
ONE q Wills and an official assessment will be issued by the PA nepartaent of Revenue.
BLOCK J B. [] The above asset has been or will be reported and tax paid eith tho Pennsylvania Inheritance Tax return
ONLY to ba filed by the dacedant's representative.
C. [] The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART [] and/or PART [] below.
PART Tf you indicate a differen~ ~ax ra~e, please s~a~:o your
relationship "1:o decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
L/NE 1. De~o Es~ebl/shed 1
2. Accoun~ Balance ~
3. Porcen~ Taxable $ ~
~. Aeoun~ Subjec~ ~o Tax ~
5. Debts and Deductions ~
6. Aeoun~ Taxable ~
7. Tax Ra~e 7 ~
8. Tax Due ~
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRTPT[ON AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penalties of perjury, T declare ~he~ ~he fac~s I have reported above are ~rue, correc~ and
WORK c 7J l/ql 4
TAXPAY~ S]~NATU~ TELEPHONE NUMBER DATE
GENERAL ZNFORNATZON
1. FA/LURE TO RESPOND #ILL RESULT ZN AN OFF/C/AL TAX ASSESSMENT with applicable interest based on information
submitted by the financial institution.
2. Inheritance tax becomes delinquent nine months after the dacedsnt"s date of death.
3. A joint account is taxable even though the decedent's name ems added as a matter of convenience.
4. Accounts (including those held betaaen husband and mile) ehich tho decedent put in joint names within one year prior to
death ara fully taxable as transfers.
S. Accounts established jointly beteeen husband and eife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTZNG [NSTRUCTZONS- PART 1 - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit thee with your chock for the amount of
tax to the Register of Wills of the coun~ indicated. The PA Department of Revenue mill issue an official assessment
(Fora REV-1548 EX) upon receipt of the return from the Register of Rills.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid ,ith tho Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt lB0601, Harrisburg, PA 171Z8-060l in the
envelope provided.
$. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and
according to the instructions below. Sign tee copies and submit thee aith your check for the amount of tax payable to the Register
of Rills of the county indicated. The PA Department of Revenue mill issue an official assessment (Fora REV-1S4B EX) upon receipt
of the return from tho Register of Hills.
TAX RETURN - PART 2 - TAX COHPUTATTON
LINE
1. Enter the date the account originally was established or titled in the manner ex/sting at date of death.
NOTE: For a decedent dying after 1Z/1Z/lZ: Accounts ,hich tho decedent put in joint names within cna (1) year of death ara
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transfaraa regardless of the value of
tho account or the number of accounts held.
If a double asterisk (ex) appears before your first name in the address portion of this notice, tho $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Enter the total balance of the account including interest accrued to the date of death.
5. Tho percent of tho account that is taxable for each survivor is determined as folloes:
A. The percent taxable for joint assets established more than cna year prior to the decadant's death:
I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT ORNERS SURVIVING JOINT OWNERS
Example: A joint asset registered in the name of the decedent and tee other persons.
I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created aithin one year of the decadant's death or accounts caned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the nasa of the decedent and tho other persons and established ~ithin one year of death by
the decedent.
I DIVIDED BY Z [SURVIVORS) = .50 X 100 = 507. (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 33.
S. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (1ina 7) as determined bates.
De~e of Death Spouse Lineal Sibling Collateral
07/01/9q ~o 12/$1/9q
01/01/95 ~o 06/30/00 OX 6X 15X 15X
07/01/00 ~o presen~ OX q.$Z~ 12X
-Tho tax rate imposed on thc net value of transfers frei a daceas~ y years ~Joungsr Bt
death to or for the usa of a natural parent, an adoptive parent, or a stapparsnt of the child is OZ.
The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
ehethar or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendents, ,bather or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "SibLings" ara defined as individuals eho have at least one parent in common eith tho decadent, whether by blood
or adoption. Tho "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTTONS - PART 5 - DEBTS AND DEDUCTTONS CLATMED
Allocable debts and deductions ara determined as folloos:
A. You legally are responsible ~or payment, or the estate subject to administration by a personal representative is insufficient
to pay tho deductible items.
B. You actually paid the debts after death of the decedent and can ~urnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper & 1/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 000999
SHELLEY KIMBERLY
3521 MARCH DR
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 206-32-4175
FILE NUMBER: 2102-0302
DECEDENT NAME: SHELLEY PATRICIA
DATE OF PAYMENT: 03/25/2002
POSTMARK DATE: 03/1 6/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/1 6/2001
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02103861 $76.61
REMARKS:
TOTAL AMOUNT PAID'
$76.61
SEAL
CHECK//5236
INITIALS: JA
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG,, PA 17128-0601
KIHBERLY SHELLEY
5521NARCH DR
CAHP HILL
CONHONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
PA 17P!i
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTXON~, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
i':~: DATE 0q-29-2002
ESTATE OF SHELLEY
DATE OF DEATH 12-16-2001
FILE NUNBER 21 02-0502
COUNTY CUHBERLAND
'02 f~P~ 29 F': :2!-~ SSN/DC 206-$Z-q175
ACN 02105861
Amount:
REV-I;48 EX AFP (01-OZ)
PATRICIA
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
~ RETAXN LOWER PORTION FOR YOUR RECORDS
REV-X548 EX AFP (01-02)
NOTICE OF INHERXTANCE TAX APPRAXSENENT, ALLOWANCE OR DZSALLOWANCE OF
DEDUCTIONS, AND ASSESSNENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 0~-29-2002
ESTATE OF SHELLEY
PATRICIA DATE OF DEATH 12-16-2001 COUNTY CUHBERLAND
FILE NO. 21 02-0302 S.S/D.C. NO. 206-32-~175 ACN 02103861
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOXNT OR TRUST ASSET ZNFORNATZON
FINANCIAL INSTITUTION: WAY POINT BANK ACCOUNT NO. 30011~617Z
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIHE CERTIFICATE
DATE ESTABLISHED 07-OZ-199Z
Accoun~ Balance
Percen~ Taxable
Amount Sub~ec~ ~o Tax
Debts and Deductions
Taxable Amoun~
Tax Ra~e
Tax Due
TAX CREDZTS:
1,021.50
X 0.500
510.75
- .00
510.75
x .15
76.61
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBNIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYHENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
*"REGISTER OF WILLS, AGENT.'*
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
03-16-2002 CD000999 3.83 76.61
TOTAL TAX CREDTT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE:, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REI~U'rRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" { CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
80.qq
3.83CR
.00
3.83CR
PURPOSE OF
NOTICE:
To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z~ of gO00. (TZ P.S.
Section 91q0).
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF NILLS, AGENT.
A refund of a tax credit, which Has not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ere available at the Office of
the Register of #ills, any of the g3 Revenue District Offices or by calling the special gq-hour answering service
for fores ordering: 1-800-$6Z-Z050; services for taxpayers with special hearing and or speaking needs:
1-800-qqT-$OZO iTT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ZB-iOZ1, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 17lg8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) far an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ)
discount of the tax paid is allowed.
The lSZ tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z
bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .00016q.
All taxes which became delinquent on or after January 1, 19BZ will bear interest at a rate which ail1 vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 198Z through ZOO2 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198g ZOZ .OOOSq8 1992 9Z .ooogq7
1983 16Z .000q38 1993-199~ 7Z .OO019Z
198q 11Z .000~01 1995-1998 9Z .OOOZfi7
1985 13Z .000556 1999 7Z .00019Z
1986 lOX .O00Z7q ZOO0 8Z .000219
1987 9Z .O00Zq7 ZOO1 9Z .OOOZq7
1988-1991 11Z .000301 200Z 6Z .00016~
--Tnterest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAXD X NUMBER OF DAYS DELXNQUENT X DA/LY XNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.