HomeMy WebLinkAbout06-20-13 BUREAU OF INOIVIDWL TAXES Pennsylvania lnheritance Tax � pennsylvania
PO BO% 280601 ���
XARRISBURG PR 17128-0601 Information Notice DEPARTMENTOFREVENUE
And Taxpayer Response "�"""°°""" `°° "'
FILEN0.21 �,7��3 —�g
ACN 13128053
DATE 05-31-2013
Type of,�ccount
Estate of MARGIE C MITCHEI� � vings
� o e�iecking
Date of Death 03-11-2012 m � c I"'14iust
ROBERT D MITCHELL � Counry CUMBERLAND �'a' = c� z o �rtificate
155 RATTLING ROCK RD � n r N � m
MARYSVILLE PA 17053-9735 y. � � O � e�
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SOVEREICN BANK provided the department with the information below indicating that at the death of the
above-named decedent you were a 'oint owner or beneficiary of the account identified.
RemR Payment and Forms to:
AccountNo.9240H8087
Date Establiahed 09-26-2007 REGISTER OP WILLS
Account Balance $14,128.43 1 COURTHOUSE S�UARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $7,06422
Tax Rate X 0.150
Potential Tau Due $ 1,059.63 NOTE': If tax payments are made within three months of the
decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Ta�c x 0.95) $(see NOTE') due. Any inheritance ta�c due will become delinquent nine months
after the date of death.
PART Ste 1 : Please check the a
� p ppropriate boxes below.
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 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 nof 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 � �pq, I am a sibling of the deceased.
3 on reverse.)
� 15% All other Yelationships(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 Tau
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 foliowing 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�dditional 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 you are makiny a correcUon W tha esEtWiahmeM dNe{Line 1)accou�t bslance(Lins 2),or percent taxffite(Line 3),
please obtafn a wHllen cortection from the Hnanclal InsNhMion mW ettech R to thN 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. En[er the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent
i. Accounta that are held"in trust for"aaother or others were 1009'0 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 Me decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners
=25%,etc.)
b. Next,divide tfie decedert's percentaye owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is detertnined by multiplying the accou�t balance by tMe parcent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting[he debts and deductions fromthe amount subject ro tax.
7. Enter the appropciate tau raze from Step 1 based on your relationship to the decadent.
If indicating a differern tax rate,please state
your relationship to the deceden[:
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
S. Tax Due 8 $
9. With 5%Discount(Tau x .95) 9 X
.S�@f 1 2: Sign and date below. Return TWO completed and signed copies to the Fiegister of Wiils lis[ed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to"Hegister of�Ils,Agent" Do not send
payment directly to the Department of Revenue.
Under penalry of perjury, I declare that the facts 1 have reported above are true,correct and complete to the best of my knowledge and
belief.
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Taxpayer Signature Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PE�YIVAliIiA E7EPAfC'fk!F�NT OF REVIEMUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-83'27. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020
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