HomeMy WebLinkAbout05-10-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
�EPARTMENT OF REVENUE
BUBEAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBUFG,PA 1�128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 017589
PROPER CHRISTINE L
121 CONODOGUINET MOBILE EST
NEWVILLE, PA 17241
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
------- �a�a ---------
13120610 � 5349.26
ESTATE INFORMATION: SSnI: 13120611 � 5168.18
FILE NUMBER: 2113-0543 I
DECEDErvr rvarwE: PROPER FLORENCE E �
DATEOFPAYMENT: 05/10/2013 �
POSTMARK DATE: 05/09/2013 I
COUNTY: CUMBERLAND �
DATE OF DEATH: 04/06/2013 I
�
TOTAL AMOUNT PAID: S517.44
REMARKS:
CHECK# 1087
INITIALS: HEA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAO oF INOIVIDUAL rnxes Penns Ivania lnheritance Tax � pennsylvania
PO BOx 280601 y DEPARTMENT OFREVENUE
HARRISBURG PA 17129-0601 Information Notice
And Taxpayer Response p`�"""°°"X" `°° "'
RECOR�f�C (?,`s=ir;=� �� acn�i �o.zosio
R E G I S 1�; =t ' ' DATE 04-22-2013
:'Oi3 f�iflY 10 Fi�1 � L ';� TypeofAccount
��E�� (;, Estateof FLORENCE E PROPER Savings
Checking
ORPHANS� ����'ti� DateofDea[h04-06-2013 r�ust
CHRISTINE L PROPER CUMBERLA�N� ;�l;},_ i;�q CountyCUMBERLAND Certificate
121 CONDOGUINET MWP
NEWVILLE PA 17241
MEMBERS isr Fcu 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.
Remit Payment and Forms to:
AccountNo.457401
Date Established 04-11-2012 REGISTER OF WILLS
Account Balance $7,76�.p� 1 COURTHOUSE SQUARE
Percent Taxable X 100
CARLISLE PA 17013
Amount Subject to Tax $7,761.21
Tax Rate X 0.045
Potential Ta�c Due $34925 NOTE': If tax payments are made within three months of the
decedenYs 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 St@p 1 : Please check the appropriate boxes below.
1
A �No tax is due. 1 am the spouse of the deceased or 1 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[he amount
shown above as Potential Tax Due.
g �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.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grandchild, etc.)of the deceased.
(Select correct tax rate at
right, and complete Part � �pqo I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none).
p �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 lorm.
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 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 of Tau Calculation $
PART Tax Calculation
3 If yau are making a correction to the establiahment date(Line 1)account balance(Line 2),or percent tauable(Line 3),
please obtain a writtan correctlon from the finencial InstRution 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"in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more[han one year prior to the date of death,the percentage taxable is 100%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 decedenYs 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 S $
9. With 5% Discount(Tax x .95) 9 X
$tep 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 ot 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
Home
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
euR�,� oF INDIVIOUAL TA:ES Pennsylvania lnheritance Tax � pennsylvania
�0 BOX 2BO6o1 DEPNRTMENTOFREVENUE
HABBISBORG PA 1�128-0601 Information Notice p¢�-�sae Ex mcExEC �oe-iv
And Taxpayer Response FILE NO.2170
ftE OI�i:Ff1 Jrf=10E OF ACN13120611
R ,.� ; Fz DATE 0422-2013
'�i3 f IflY 10 F(1 12 `12 Type of Account
Estate of FLORENCE E PROPER Savin s
CLERK Checgng
ORPHANS COUp�teofDeath04-06-2013 Tr�sc
CHRLSTINE L PROPER CUMBERLAND r ountyCUMBERLAND Certificate
121 COND06UINET MWP �U., PA
NEWVILLE PA 17241
MEMBERS isr Fcu 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.
RemitPaymentand Formsto:
AccountNo.457401
Date Established 04-11-2012 REGISTER OF WILLS
Account Balance $3,737.11 1 COURTHOUSE SQUARE
Percent Taxable X 100 CARLISLE PA 17013
Amount Subject to Tax $3,737.11
Tax Rate X 0.045
Potential Tax Due g �gg,�7 NOTE`: If tax payments are made within three months of the
decedenYs 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 St@p 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 Potentia/Tax Due.
g �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.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild, etc.) of the deceased.
(Select correct tax rate at
right, and complete Part � �p% I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �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 lorm.
E �Asset will be reported on The above-identified asset has been or will be reported and tau paid with the PA Inheritance Tax
inheritance tau 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 8 1/2"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 percent taxable(Line 3),
please obtafn a written corcection from the financial institution and attach it to this form.
1. Enter the date Ihe 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"in trust 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 100%divided
by the total number of owners including the decedent. (For example:2 owners= 50°/a,3 owners=33.33%,4 owners
=25%, etc.)
b. Next,divide the decedenYs 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 t
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
$t@p 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
Home
Taxpayer Signature Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REC.-+ISTER 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
ON LY: 1-800-447-3020
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