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Home My WebLink About06-13-13 COMMONWEAITM OF PENNSYLVANIA REV4182 EX(11-96) OEPARTMENT 4F ftEVENUE BUREAU OF INDIVIDU0.L TA%ES OEPT.280601 HAFiRi58UftQ,RA 4]t28-0801 PENNSYLVANIA RECEIVED FROM: iP1HERITANCE AIVD ESTATE TAX OFFICiAL RECEiPT No. ca o� 7�40 KERR ANNE M 419 BAER AVENUE NANOVER, PA 17331 ACN ASSESSMENT AMOUNT CQNTROL NUMBER -------- �oa ..-------- ------ 101 { 553.40 ESTATE INP4RMATtON: sSN: �s�-o3-53s2 � � FlLE NUMBER: 2113-047$ � DECEDENT NAME: KERR HELEN M � DATEOFPAYMENT: 06f13f2Q13 j POSTMARK DA7E: 06/12(2Q13 ( CouNTV: CUMBERLAND f DATE OF DEATH: 04f O6j2013 ( , TOTAL AMOUNT PAID: $53.40 REMARKS: GHECK#4996 INITIALS: D61 sen� RECEIVED SY: G�EN[}A FARNER STRASBAUGH REGlSTER OF WILIS REGISTER OF WIIIS BURFAII OF INOIVSOUAt TAXES P�nnsyivania lnheritance Tax � pennsylvania PO p0% 280601 DEPAflTMENT OF REVENUE FbtRRISBIRt6 PA 1712$•86U1 lnformation NotiGe And Taxpayer Respanse °�"'''us ex n�xcc c�a��zx FILE N0.2113-0479 ACN 7312$31$ DATE 05-28-2013 Type of Account Estate of HELEM M KERR �Savings SSN 167-03-5362 Checking Date of death 04-06-2013 Trust I ANNE KERR Counry CUMBERLAND Certificate 419 BAF„R�AYE et , �,1N�VEf�qA 17 F31B2702 � W .�.1 '��-t � � U U :'r"� � O U p 41- � � � V} � 4 O �. M W Q � � t�.; r-1 � S 1:t1 t� F"' Z � Q-�4n � N � � � _ ¢ t,p � O � .___. . ' - — s�i.l � � � � .� PNC BANK NA provided the department wiih the information belaw indicating that at#he death of the above-named decedent you were a 'oint owner or beneficiary of the account identified. A�� Remit Payment and Forms to: Dete Established 10-2B-ZOp9 REGISTER QF WILtS Account Baiarrce $2,4gg.pp t COURTHOUSE 3QUARE Peroent Taxable X 50 CARLiStE PA 1�013 Amount Subject ta Tax $1,249.00 Sau Rate X Q.045 Pptential Tax Due $5621 NOTE': if tax paymer�ts are made within three months of ihe decedenYs date of death,deduct a 5 peroent discount on the tax With 5�o Discount(Tax x 0.95} ${see NOTE'} s 53.�a due. Any inheritarwe t�due wiii become deiinquent nine monihs after the date of death. �A� S1@(} 1 : Pieas�e check the appropHa#e boxes beiow. 1 A �No tax is due. I am the spause of#he deceased ar I am fhe parent of a decedent wha wras 21 years old ar yaunger at date at death. Proceed to Step 2 on reverse. Do not check any other boxes and disregara'the amounf showrr above as Poterrfiat Taz Due. g �e information is The above information is correct,�o deductions are being taken,and payment will be sent oorrect. wittr my response. Prnceed to Step 2 on reverse. Do not check any other boxes. � �The tax rake is incorrect. � 4.5% I am a lineal beneficiary (parent,child,grandchild, etc.)of the deoeased. (Select correct tax rate at right,and complete Part � 1 p�, �am a sibling of the daceased. 3 on reverse.} � 15% All other relationships(including nona). p ❑Changes or deductions The intormatian abave is incorreci andtar debts and deductiar�s were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E �Asset witt be rapoRed on The above-identified asset has been or wili be reExtrted and taz paid with the PA tnheritance Tax inheritance tax form Return filed hy the estate representative. REV-i 5Q4. Pracsed to Step 2 ort reverse. Do not check any ather boxes. Please sign and date the back of the form when finished. PART pebts and Deductions s Aibwabie debts and deduetions musT meet both of the foliowing orfteria: A. The decedent was legally responsible for payment,and the estate is i�sufficienY fo pay the deductible items. B. You paid the debts atter the death af the decedent end can fumish proof of payment+f requested by the deparM�ent. (If additional space is required,you may attach 8112"x 11"sheets of paper.} Date Paid Payee Description Amount Paid Total Enter on Line 5 of 7au Calcuiatian $ PART Tax Calculation 3 N you arc mrklny a care•eetiqn ta Nw�tabi{shmarn dete(line t}pccqern#i�Iance{l�},or pBrGrrt tax#bIs(Line 3), __ plesre oMaln a w�ccrtrectlon firom the Hnenclal h�sHlution and alt�ch R ta thi� 1. Enter the date the accpunt w8s established or titled as it sxisted aT ihe date of death. 2. Enter the total balance of the account including any interest accrued at the date af death. 3. Enter the percentape of the account that is taxable to you. a. First,determine the percqntage owned qy the decedent. i. Accaunts tttat are hek3 in trust for"another pr others were 1 d0%owned by the der.edent. ii. For joint aecourrts ' mwe than one year prior to the date of death,the percerNaqe tauable is 10d%div�Ied by the total number of ow�ers including the de�edent. (For exampls:2 awnets=50%,3`lfw�tor�=33:33%,4 iwmers =25%,elc.} b. Next,divide the decedent'a percen$�gR oamed by the number of surviving owners or beneflciaries. 4. The amount subject to tax is deteEmined tsy muCtepiyir�the account balance by th8 pareaM taxable. 5. Enter the 2otal of any debts and d9ductions Gaimed from Part 2. 6. The amount tazable is determin�l by subtracting the debts and deductions from the amount subject to tau. 7. Enter the appropriate tsu rate hom 8top t based on your relallonship to the decedent. If i�rciicating 8 dHferqnt tax tate,pl0�rse state your rel�tiiSnship to the decedent: t. Date Estabiished 1 2. Account Balance 2 $ 3. Percent Taxab�e 3 x 4. Amourrt Subject to Tax 4 $ 5. Debts and Deductions 5 - 8. Amount Taxable 6 $ 7. Tau Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount(Ta�c x.95) 9 X 'r„�"�@�} Z. S3gn and date bekaw. Retum T1#IO comptated and signed copies ta the Regi�ter of Wiils Iisted on the tront af this form, alorrg w}tt�a check far any payment you are makirtg. Ghecks must he made payabie to"Registe�af NRNS,Agent" Da nat send payment direct�y to the Department of Revenue. Under penaliy of perjury, 1 deciare that the facfs i have reparted abave are true,correct and complete to the best bf my knowiedge and belief. Work ,t c.�t,�.:� Homet� �,� 9�s- ,9��- G !a /3 T�payer Signature Teiephane Number ate IF YOU NEEb FURTHER ASSISTANGE; CON'fACT C1Jt�AF��FtLAtVD GC�#1d�tl' R�GIS'TER {JF 1NILLS, PA DEpARTMENT OF REYENUE DISTR}GT OFFIGE, OR THE INNERITANCE TRX t}IY€SlON RT �17-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL NEARING ANDlOR SPEAKING NEEDS ON[.Y: 1-$00-447-3020 =A D i �� O�p. m�m VD� D� V � I t M• � �� \ �,,� 47 � aa A � � 4 T O� �. t�1 � C ce ' , u�t! � `I. (� A T � o c p ' ' � � � � � . _ V �� u C� = e '� ` � = � ,�o � � � _ U� � �u �`3 . _ � � � � _ � F� � - P- N� ` =. � 4 � � � r `.L"�::r O � :. r . _ �. � � ;�., ; - _ s ,� ;,.,, _—_... , ._. ,. ,�� P , ..� . a ��:-.