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Home My WebLink About05-21-13 COMMONWEAITH OF PENNSVLVANIA REV-1162 EX(i 1-961 DEPARTMENT OFflEVENUE BUREAU OF INDNIDUAL TA%ES DEPL 280601 HARRISBUFG.PH 1�128�Ofi01 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017641 DIEHL LAVERA B 2706 HARVARD AVENUE CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER _""'_ roia ____"' "_""' : 13123913 � S 1 19.53 ESTATE INFORMATION: ssN: 13123911 � 5.40 FILE NUMBER: 2113-0580 � DECEDENT NAME: DIEHL WILLIAM J � DATEOFPAYMENT: 05/21 /2013 � POSTMARK DATE: 05/20/201 3 I CouNrY: CUMBERLAND � DATE OF DEATH: 01/22/2013 I � TOTAL AMOUNT PAID: 5119.93 REMARKS: CHECK# 1504 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTEF OF WILLS _ _ _ _ euaEnu oF ir+orvioua� rnxes Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 �� DEPARTMENTOFREVENUE HARRISBURG Pp ll128-06D1 Information Notice ecv-isaa cx uecexec cae-�a And Taxpayer Response FILE N0.2�7d 21 � J3'�S�O ACN 13123913 r t�r DATE 05-OS-2013 REGISTE�t U� �':. f_S Type of Account C!ii3 f IflY 21 � � 1 �-5 Estate of WILLIAM J DIEHL Savings SSN X Checking C LE�?K G Date of Death 01-22-2013 T�usc JOHN R DIEHL . ,. -, CountyCUMBERLAND Certificate 2616 YALE AVE ORPHA(d"s �rUU7tT CAMP HILL PA 17011�r��R��'!L �i�,�'.. �'r� BELCO COMMUNITY CREDIT UNION 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: Account No�3?760 . Date Estabfished 07-01-1975 " REGISTER OF WILLS Account Balance $ 15,937.03 1 COURTHOUSE S�UARE Percent Taxable X 16.6fi7 CARIISLE PA �70�3 Amount Subject to Tax $2,65622 Tax Rate X 0.045 � Potential Tax Due $ 119.53 NOTE':�If taac ayments are made within three montfiS of the decedent's ated`-oiTle�ath,ti�ducT a 5pe�cent�sL�nt 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 Step 1 : Please check the appropriate boxes below. � A �]No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years otd or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and dis�egard the amount shown above as Potential Tar Due. g �The information is The above intormation is correct, no deduciions 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. d 4.5% I am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part � �2% 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 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 tau iorm Return tiled by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any o[her 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 corcection to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtaln a written correction from the financfal InstRutlon 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[o 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 Ihe 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%,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 tan rate from Step 1 based on your relationship to the decedent. If indicating a different ta�c 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 Wilis 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 bes[of my knowledge and beliet. � � Q Work �/I '7`�3 '�-�4 � ,,, ,u_,I� Home -� �-� y 3/ t/'-/� ° 5 a� /3 T payer ignature 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 . BUREAII OF INUIVIOUAL TAXES Penns Ivania lnheritance Tax � DennsYlvania PO BOX 2B0601 Y • + HAftRISBURG PA 17128-06a1 Information Notice DEPARTMENTOFREVENUE And Taxpayer Response "� 154"°°""``�°_", � FILE N0.2fi70�,�/-/,3� C�,�b'v ACN 13123911 ;�-�r r; r DATE 05-08-2013 RECisr�:,= c,= .�!: �..s Type of Account Iui3 f i�Y 21 ��I�t i �5 Es[ate of WILLIAMJ DIEHL Savings SSN �Checking C L E l�i� i;i= Date of Death 01-22-2013 TrusC JOHN R DIEHL CountyCUMBERLAND Certificate 2616 YALE AVE ORPNdNS� CO.1P�1 CAMP HILL PA 17011- C�I�ERLAND CO., PA aE�co COMMUNYTY CREDIT UNION 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. AccountNo.32760 Remit Payment and Forms to: Date Established 07-01-1975 REGISTER OF WILLS Account Balance $53.81 7 COURTHOUSE S�UARE Percent Taxable X 16.667 CAflLISLE PA 170�3 Amount Subject to Tax $g.g7 Tax Rate X 0.045 NOTE': If tax payments are made within three monihs of the Pote�tial Tax Due $0.40 decedenYs date of death,deduct a 5 percent discount on Ihe 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. PaR7 St@p 1 : Please check the appropriate boxes below. i A �No tax is due. I 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 Ihe amount shown above as Potential Tax Due. g �The information is The above information is correct, no deduccions are being taken, and payment will be sen[ 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 � �2% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The intormation above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropnate 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. _ PA�T 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 Calcutation 3 If ou are makin a correction to the establishment date Line 1 account balance Line 2 ,or y g ( ) ( ) percent taxable(Line 3), please obtafn a written correctlon from the financisl 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"in trust for"another or others were 100°/a owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage ta�cable is 100%a 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 trom 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 7 based on your reiationship to the decedent. If indicating a different tax rate,please state your relationship to the decedent: 7. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subjec[to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. 7ax 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 musi 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 -7�'� 7 fr3 29 �-!l �'la�,� �. ,9� Home -r/� �3 � �l`l l° 5� �o� i3 Tazpayer 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 71 _Z7$7_832�:—v''ERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 � m � � � �`� � J Q ` -�C � �E " Y �^E O:f ` ,� �.. � RE, � � � 01- fri'_!aS ;i�;3 P�h'r ?1 ,r-;�' i 25 ��1� c CL`_�:�� . , ORPHA;a�' Cr�iJ�T CUMBERLk�,idr,? �^,�„ pp � � � A � Z \ P `^ �..w A � � �°� � �. ,..�. �.) Q � �,r � c � �{t � k �n �e t.? U1 � � J �� a c � � � W � '.,x� _ � �� .�`, . — � ;;� �� — � '� — �r s� = r p,� _ �s��.''3 . ` ' . . .' � � IN � n (p r+