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HomeMy WebLinkAbout06-05-13 COMMONWEAI.TH OF PENNSVLVANIA REV-1�62 EXI11-96) �EPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA%ES OEPT.28060t HARRISBURG,PA 11128-Ofi01 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFlCIAL RECEIPT N0. CD 017704 BYRON J WILLIAMS JR 361 POLECAT ROAD LANDISBURG, PA 17040 ACN ASSESSMENT AMOUNT CONTROL NUMBER -— mia -"'__"' __'_' 101 � 537.58 ESTATE INFORMATION: ssN: I FILE NUMBER: 2113-0632 � DECEDENT NAME: WILLIAMS BYRON J � DATEOFPAYMENT: 06/05/2073 I POSTMARK DATE: 06/05/2013 � CourvTY: CUMBERLAND � DATE OF DEATH: 04/23/2013 I � TOTAL AMOUNT PAID: 537,58 REMARKS: CHECK# 378 INITlALS: BAJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTEFi OF WILLS BUREAU oF INDIVIOVAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BoX 28a6a1 DEPHRTMENT OF REVENUE ^ HARRISBURG PA 1]128-0601 Information Notice aEVasae�x ro�cxEC �naan � And Taxpayer Response r'� �1 FILE NO.2170 ,�/'—'O ACN13124612 '�_. `�" DATE -10-2013 :�' � m � c— �? O � �1 G � rn = c�Typ�of as'so�it Estate of BYRON J WlLLI�2 rr*rn .L %� Savings SSN �' u? � c> � Checking B J WILLIAMS JR CountyCUMBERLAND13 � p ..�,.y 3 -"- — Certficate 361 POIECAT RD p C " LANDISBURG PA 17040-9239 _ � ""C �— Q v N � -n m V� 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. Account No. 10788 Remit Payment and Forms to: Date Established 04-13-2000 REGIS7ER OF WILLS Account Balance $5,273.91 1 COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $879.00 Tax Rate X 0.045 Potential Tax Due $39.56 NOTE': If tax payments are made within[hree months ot the decedenYs date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE`) 7,S S� 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 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 incorrec[. � 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 deduc[ions The information above is incorrect andlor debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back of this/orm. 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-7 500. 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 obtain a written correction from the tinancial instRutioo and attach it to4his 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 a[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 7 00%owned by the decedent. ii. For joint accounts established more than one year prior to[he date of death, [he 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 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 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 fac[s I have reported above are true, correct and complete to[he best of my knowledge and belief. Work Home � r� - Z - - r 3 Tax yer 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 � � � _ �-- �C � � � � � � � � '� � a-. � 0 � a ;,. � -� ....i ��' � � r. �,� r- b �r '" v � � a? � i\) �' � O� J � � � - � �� r' �. _ � �- �, ,; VJ A `� ;. �" ► - i.; ,., _ ,te _ ;�, r, � - +� �� - �,. r �..; �� Sti ' �r .�, y - � '�, „ _ v� •�o� aNVia3ewn� {. `:, _ sano� .sNVHdao '` � = �o �a3i� � ., a:t�:��, _ 9Z h Wd h Nf1� E:�1. " F�=,.::�. ' s��i���� �o Yt.�wsi��a ` '��`' "_ j0 ��^I�.�O q��r;d�3t� o � y P;. 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