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Home My WebLink About04-25-13 SUREAU f1F INDIYIDUI4L TAXES � pennsylvan�a Po aox zao6o� Pennsylvania lnheritance Tax HARRISBUR� PA 17128-Ob01 Information Notice d��'�RTMENT OF REVENtlf And Taxpayer Response REV-1543 EX DocEXEC{08-12) F1�E NO.zi i a-osol ACN 13031383 DATE 04-02-2013 � �° i � ,. �,: ��(�� ►��i �� '�r.,�,� Type of Account �� "�E�ta�t�G CHRiSTL{EB Savings Checking SUSAN NAUGLE ��-��r� ��ounty CUMBERLAND�� Cert ficate �50 RED PATCH AVE ('��C�' �;��`� GETTYSBURG PA 17325-2423 ��8�� ij �� REAL ESTATE provided the depar#ment with the infiormation below indicating that at the death of the above-nam�!decedent you were a jaint owner or beneficiary af the accaunt identified. Remit Payment and Forms to: Account No,0 Date Estabi�shed 06-14-20�o REGIaTER QF WILLS Account Balance $2�,4�p,pp 1 COURTHOUSE SQUARE Percent Taxable X 8.333 CARLISLE PA 17�13 Amount Subject to Tax $1,788.26 Tax Rate X 0.120 NOTE*: If tax paymen#s are made within three months of the Potential Tax Due $�14•�� decedent's date of death,deduct a 5 percent discount on the ta�c With 5°la Discaunt(Tax x 0.95) $(see NQTE'`} due. Any inheritance tax due will become definquent nine months after#he date of death. PART r�t�� 1 ; p�ease check the appropriate baxes below. i � A �No tax is due. 1 am the spouse of the deceased ar 1 am the parent af a decedent wha was 21 years ald or yaunger at date af death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amounf shown above as Poferrtiat Tax Due. g �The infprmation is The above information is correct,no deductians are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do naf check any other boxes. C �The tax rate is incorrect. � 4.5°l� 1 am a lineal beneficiary{parent,child,grandchild,etc.)af the deceased. {Select correct tax rate at right,and camplete Part � j�a{o 1 am a sibling of the deceased. 3 on reverse.} � 15°la All other relationships(including none}. p �Changes or deductions The information above is incorrect and/or debts and deductians were paid. listed -�=� Complete Part 2 and part 3 as appropriate on the back of this form. E Asset wil!be reported on The above-identified asse as been 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 nof check any other boxes. Please sign and date the back af the form when finished. PART Debts and Deductions 2 Aliowable debts and deductions must meet both of the foifawing criteria: A. The decedent was fegaffy responsible for payrnent,and the estate is insufficient to pay the deductibie items. B. You paid the debts after the death of the decedent and can fumish proof of payment if requested by the deparkment. (If additianaf space is required,you may attach 8 1/2"x 11"sheets of paper.} Date Paid Payee Description Amoun#Paid Total {Enter on Line 5 of Tax Calculation) $ PART Tax Galculatian 3 If yau are making a correction to the establishment date(Line 1}account balance{Line 2),or percent taxabie(Line 3}, please al�tain a written carrection from tl�e#inar�cia!ins#itutio�and attach it to this f�*rm. 1. Enter the date the account was established or tit(ed 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 af the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts#hat are held"in trust for"anather or athers were 10Q%owned by the decedent. ii. For jaint accounts established mare than one year prior to the date of death,the percentage taxable is 1 QO°!a d'+vided by the tata! nurnber of owners including the decedent. (For example:2 owners=5Q°la,3 owners=33.33%, 4 owners =25°Ia,BtC.} b. Next,divide the decedent's percentage awneci by the number of surviving owners ar 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 amaunt subject ta tax. 7. Enter the appropriate tax rate from�tep 1 based on yaur relationship to the decedent. If indicating a different tax rate,please state ° ' ' " your relat+onship ta the decedent. �� 1\ , `�'��p�� 1. Date Established 1 .� � � .�: , ,..:. �� .. ��"�. �� 2. Accoun#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 � �___.�.�_ � �� w��; 8. Tax Due 8 � � �� , ,� 9. With 5°la DiSCOUnt(Tax X .95) 9 X �.:.:!:. ;.. . , � � ,...... , '�J�G�? 2: Sign and date below. Return TW4 completed and signed copies to the Register of WiNs!is#ed on the front of this form, along with a check far any payment you are making. Checks must be made payable to°Register of Wifls,Agent." Da not send payment directly to the Deparkment of Revenue. Under penalty of perjury, I declare that the facts I have reported above ar�tru�,correct and complete to the best ofi my knawledge and belief. r ,° j� , Work .�� , j . '/ ��c,-,,, �,� ,�� +�..;�,-�4 r -t..,f. Home ?j �~- � > c� ._,,i/ `�r.�--- '� Taxpayer Signature Telephone Number Date ,��!�� IF YC}U NEED FURTHER ASSISTRNCE, CC}NTACT CUMBERLAND Ct�UNTY REGISTER QF WILLS, PA DEPARTMENT (�F REVENUE Q15TRICT t�FFlGE, C?R THE INHERlTANCE TAX DIVISI4N AT 717-787-8327. SERVlCES FQR TAXPAYERS WfTH SPECIAL HEARIIVG AND/OR SPEAKING NEEDS ONLY: 1-8Q4-447-3Q21� �� '�� 4� �_ ��C�F��C� �Y��',�'�"„ ,�� ,� �;o h�� ' �;��!..�� ' �'�:��3 A�R 25 �;`� �� y� �L��t� �_:_� . {��f��s;��' `!:�U R T�� CUMBERL��; CO., P� � � � �i �. � � � � � � w � �' � ° � � 't� ' �, � " � �: � , ,� � � .�:. � � � .. � � �,� �;_ � .- �,; �� . �j �A �� ?`:7 �. :..` � � �= :F „� , �;.y:� � � � �� . .1�� . .. "La , 1 � �� `� ti{I .�.. . � �. «... J �. � '�, ..:.. '�^' ' . � � � � �•� �� .w �^�;.. .�.. � ti.., s=� . ... � ..:�. ++. n .�a:l... �� w.w ' r � � f � � `X�. .+.� �t.* "r" �.r. �a.. wr" •i � �• x,' � FOREVER� �. �� E� � z t � � �: ��