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Home My WebLink About05-30-13 fOMMONWEALTH OF PENNSYLVANIA flEV-1162 EX�11-96) DEPARTMENT OF REVENUE NUREAU OF INDNIDUAL TAXES UEPL 280601 HAFRISBURG.PA 1 J128-Ofi01 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017685 DANIELLE CARBONE 4713 A CHARLES RD MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER — mie 13126722 � 511 .08 ESTATE INFORMATION: SSrv: � I FILE NUMBER: 2113-0612 I DECEDENT NAME: HEICHER EDWIN C � DATEOFPAYMENT: 05/30/2013 I POSTMARK DATE: 05/29/2013 I CouNTY: CUMBERLAND � DATE OF DEATH: 05/O8/2013 I � TOTAL AMOUNT PAID: $11 .08 REMARKS: CHECK# 724 INITIALS: HEA sEn� RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS _ _ eueEnu oF iNpivtow� rnxES Pennsylvania lnheritance Tax � pennsylvania PO BOX 28u6U1 DEPARTMENT Of REVENUE HARRISOURG PA 1]128°0601 Information Notice And Taupayer Respo�se «E.-�s��x o«E=F<<oa-,�� s ECi�;ti� �'"" �1;"" FIIENU�-- t� '— �l� ' ACN 1�126722 ��t`' i . ,ti �J f' . ;; DATE 05•21-2013 ��i:f f`i�iY ,i(i ';: i . � '', � ' ` 7ype of Apopunt U L� 34 '. �state ot EDWIN C HEVCHEfi Savings ��`�i5 �' Dat�of Deat 053p8-2013 x T ustking DANIELLE CARBONE CUM6ERL�Pz ",�Cbunty�'GUMBERLAND Certificate APT A 4713 CHARLES RD MECNANICSBi1R6 PA 1705U-773U MEMBERS i sr Fcu provided the department with the information below indicating that at tha death of the above-named decedent yau were a 'oint owner or beneficia of the account identified. Account No.12060 Remft Payment and Fomis to: Date EsWblished 02-2]-2010 REGI37ER OF WILLS Account Balance $468.53 1 COURTHOUSE SUUARE Percent Taxable X 16.667 CAR�ESLE PA 17013 Amount Subject to Tax $77.76 Tex Rate X 0.150 NflTE': if tax payments are made within three months of the Patentiai T�Due $71.68 decedanYs date of death,deduct a 5 percent discou�t on the tax With 5%Discoun4(Tax x 0.95} $(see NOTE`) /),qb' due. Any inheritance tax due will become delinquant nine months after the date of death. PART ca,t�p 1 : Piease check the appropriate baxes bataw. ti � �No tax is due. 1 am tfie spouse af the deceased ar i am the parent of a decedent who was 21 years oid or younger at date of death. Proceed to Step 2 on reverse. Dp not check any othar boxes and disregard the amaunt shawn atrove as Potentia/Tax Due. g �-The informatian is The above information is correct, na deductions are being taken,and payment will tre sent correc[. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � ❑The tax rate is incorrect. � 4.5°la I am a Iineal beneficiary{parent,child,grandchild,etc.}o#the deceased. (Select correct tax rate at right,and complete Part � 12�, I am a sibling of the deceased. 3 on reverse.) �" 15% AII other relatianships{includi�g none). p �Ghanges or deduciions The infarmation above is incorrect andlar debts and deductians were paid. Iisted. CompJets Part 2 and part 3 as approprrate on fhe back of this form. E �Assei will be reported on The above-identified asset hes beeo or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return fiied by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do nof cheok any other 6oxes. Please sign and date the back of ihe farm when finished. PART Debts and Deductions 2 Albwable debts and deductions must meet both of the following criteria: A. 7he decedent was iegally responsible ior payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can fumish proof of payment if requested by the department. (if additionai space is required,yau may attach S i!2"x 11"sheeTS of paper.) Date Paid Payee Description Amount Paid Totai Enfar on Une 5 of Tax Calculation) $ PART Tax Calculation � H ou are makin a correction to the estabFishmeM date Eine! accaunt balance(�ine 2,ar y g { } ) percent tax�te(tine 3}, please obtain a written correction from the financiai institutipn and attach it to this form. 7. Enter the date the accaunt was established or titled as it existed at the date of death. 2. Enter the totaf balance of the account inciuding any iMerest accrued at the date of death. 3. Entee the percentage of the account that is t�able to yqu. a. First, determine the percentage owned by the decedent. i. Accounts that are held"in trusF for"another or others were 100°h owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100°10 divided by the totai number of owners inciuding the decedent. (For example:2 owners=50%,3 owners=33.33%, 4 owners =25%,etc J b. Nex[,divide the deceden['s percentage owned by the number ot surviving owners or benefioiaries. 4. The amouM subject to tax is determined by multiplying the accaunt balance by the perceM taxable. 5. Enter the totai of any debts and deductions ciaimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions frpm the amount subject to tax. 7. Enter ihe apprppriate tax rate from Step 1 based on your relationsbip to the decedent. If indicating a different ta�c rate,piease state your relatipnship to the decedent: nio.�et' t. DateEstablished t .�-.�?-�G/¢ 2. Account Ba(ance 2 $ �L�� S 3 3. PerCent Taxable 3 X /6 �G 7 4. Amount Subject to Tax 4 $ ?7 �G 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ /f 6 6 7. Tax Rafe 7 X !l- !S"� 8. Tax Due 8 $ l/, Gj` 9. With 5%Discount (Tax x .95) 9 X �t@�} �: Slgn and date below. Retum TWO wmpieted and signed copies#o the Register oi Wilis Iis#ed on the fronf oi fhis Porm, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." L10 not send payment directly to the Department of Revenue. iJnder penalty of perjury, I deciare that the facts 3 have reparted above are true,correct and complete to the best of my knowledge and beiief. "`� wo�kt�7r7i Sa�?� 6v�� Lor��,Y,G:� ��e Home 7t7��-�R81 _fa� r�' Taxpayer Signature Telephane Number Date IF YOU NEEd FURTHER ABSISTANGE, Ct}NTAGT CUMBERLAND COUNTY REGtSTER 4F WI��S, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE iNHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WI7H SPECIAL NEARING AND/dR SPEAKING NEEDS ONLY: 1$QQ-447-342Q �i�� az �p �Q Ol !°A 6 A D � N � O Q J J O { \ V \ �^ 1'e � 1 q �: ..� ?p C � C. ,?r! - C7 ^�"� WF r cC � " �' C! 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