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Home My WebLink About06-10-13 __ __ BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REV-1543 EY OocE%EL (OB-12) And Taxpayer Response FILE NO.�t�9 ZJ-/3• OlQS� REVISED NOTICE ACN 13119225 * * * * * * DATE 05-08-2013 Type of Account Estate of AUDREY L BAKER Savings SSN X Checkin�p, Date of Death 03-18-2013 Trust BETH A WILEY CountyCUMBERLAND Certifica�� 1113 SHANNON LN CARLISLE PA 17013-1784 G'� `_' � C w � � � � � � C � a n't y cy z �n �s a �,,, r,�, o � rc� � � � -v � � � c� � -t; -r�- -�i *.� �.� ... � -r� . � � �.� e�`i � c,� en o METRO BANK provided the department with the information below indicating that at the deathfoi�the � above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.537376451 Date Established 06-28-2006 REGISTER OF WILLS Account Balance $1,158.59 1 COURTHOUSE S�UARE Percent Taxable X 50 CARIISLE PA 17013 Amount Subject to Tax $579.30 Tax Rate X 0.150 Potential Tax Due $86.90 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 Step 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 c ect. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C 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 � 12qo I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p hanges 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 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 4 �Au,g BA dz J'rz Ru�,bv �+►► 0 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 financial 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%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%,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 multip�ying 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,plea�s UG� your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 1�Sg. 3. Percent Taxable 3 X � 4. Amount Subject to Tax 4 $ s7R• 3(� 5. Debts and Deductions 5 - �� 6. Amount Taxable 6 $ d•OO 7. Tax Rate 7 X `�S 8. Tax Due g $ 0•�U 9. With 5% Discount(Tax x .95) 9 X O. � ,,, 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 Wil�s, 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 -�2�-�'�1 '�7�7 � Home ` � -'�$�Co axpayer 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 ON LY: 1-800-447-3020 _ __-- ---- ----�--_..,�....�,. _ �A I� PA Department of Revenue Inheritance Tax Information Notice And Taxpayer Response ESTATE OF ACN NUMBER AUDREY L. BAKER 13119255 DOD 3/18/2013 SSN EXPLANATION OF DEBTS AND DEDUCTIONS I,Beth A. Wiley, have used funds from Metro Bank Account 537376451 held jointly with my mother, the above referenced decedent to reimburse my stepfather,Jacob H. Baker,Jr., the amount ' of$1158.59, or the total date of death value of the account for funeral expenses paid to Ronan Funeral Home for my mother's funeral and burial on June 4, 2013. � c� I� I � Dated Beth A. Wiley I,Jacob H. Baker,Jr., hereby acknowledge receipt of the sum of$1158.59 from Beth A. Wiley as reimbursement for funeral and burial expenses paid to Ronan Funeral Home for my wife,Audrey L. ' Baker's, final expenses as evidenced by the attached receipted bill from Ronan Funeral Home. ' t/ 013 �� Da d ob H. Baker,Jr. ' - _ _ _---- e11� A�tE��B�u�R 747 BETtt 1►Yvii.EY 44+5 E LOUTHER 37"REEI" so-t8ust3 C�tRLiS1E,PA f7013 � � 11 717.2�0-582� Date � Pay to the � c� -' �,.��''" $ 1(�� - Orc�er af BKw,,. Dollars 8 g�n.«� � i,as��:ono� _ w�m+,e.v��nr For - +� �: , ? �� . P _ __ — :d�_ ___ _ _ _ _ ��I� i`v1ia�� ,.�,.., �- -- 255 V o�k Road Ca�1�s\e,P A 11013 `J � TeL 717-258-9863 Fax: 717-241-4041 Lynn A. Ronan, Funeral Director Friday, April 5, 2013 Mr. lacob H. BAKER 145 E. Louther St. Carlisle, PA 17013 Dear Mr. BAKER, ', Thank you for selecting our funeral home to provide services for your family during your time of bata�cmeat. i�opc tYt�r found our services, so far, to be of the highest stan�ds that we always try to achieve_ T6e foibwing is a�ry of�e service charges as previously explained and provided in written form on the services for. AUDREY L.BAi�dt, ' PROFESSIONAL SERVICES Basic service of funeral director and siaff a 3,410.00 Other Preparation of Body ' Crematory Fe S Incl. ' Total Funeral Service Selected S Incl. ' Use of Facilities & Staf�'for Visitation TOTAL PROFESSIONAL SERVICFS 53,410.00 Use of Facilities& Staff for Memorial Service at Funera! Home S IncL Transfer of Remains to Funeral Home S 1ncL OTHER 11�RCHANDISE SELECTED S 1ncL ' Minimum Alt. Container � Keepsake Um Memorial Package Tri-fold #2 S 130.00 ' Urn/Vase White Marble S 225.00 ' Cq��V�� TOTAL OTHER 11�RC�q�ISE SELEC�TED Certified Co�pies of Death Certificate Sb55.Op ' Newspaper Natice Sentinel a 72 p0 Coroner Authorization $ 225 28 Flowers S 30.00 TOTAL OF SERVICES CASH ApVA]VCE T�OT�AL 5459.78 54,524.78 tf there are B'�I'ANCE DUE —�--�.�._ �Y 9�estions or concerns that re�tairi ur►answer ' Sincerely, �'p�e��»me. , _.i� ,� ' ,�-��; �� Casl� �dvar�c-�S A�� (� 3L/r�'/�8 "�.__- C.�sl� Ad,x�,,� eS 13�d�e �-cd 5 �f 2 ,', 5 0 �� C-�`cSG. Ad✓ �....��,'e.. ! 2` '� g �sa/�t (�z� / 3� , �r� �� - � �� ZZZ . �. $ �- ____-_--' C��vt, _ � � �3 °� �/ � -- - _----- __ ___ __ _ _ ,y�� __