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Home My WebLink About06-28-13 B��° o� I�ro=YZ°�,� T,�E$ Pennsylvania inheritance Tax � penn�rlvania Po BOX 2R06ai DEPARTMENT'OFflEVENUE IWRRISBURG PA 1�128•0601 Information Notice AEV-�56L E{OooEffi{t�E'i25 And Taxpayer Response FILE NO.2113-��85 REVISED NC7TICE ACN isi2s387 � � � � � � DATE 06-25-2013 Typ�of Accpunt Estate of HANS S ROMBERGER Savings Checking Date of t}eaih Ot-13-24t3 Trust MARY .l RoMBERGEe County CUMBERLAND Certificate 6109 SMITHFIELD ST NARRIS8UR6 PA 17112-3532 i PNC BANK NA provided the department with the information befow indicating ihat at ihe d�ath of the above-named decedent ou were a joint owner or beneficiary af the account identified. Accpunt No.5140CI53684 Remit Payment and Forms to: Date Established 11-17-2809 REGISTER 8F WILLS Accnunt Balanae $1p,��,pQ 1 COURTHOUSE SQUARE Percent Taxab�e X 16.667 CARI�StE PA 17p13 Amount Subject to Tax $2,443.71 Tax Rate X 0.750 Potentia!Tau due $306.58 NQTE': !f taac payments are made within three manths af the decedent's date of death,deduct a 5 percent discount on the tax With 5°/,Discount(Tax x 0.95) ${see NOTE') due. Any inheritance t�due wilf become d�linquent nine moMhs aker the date of death. PART c��8p 1: Please check the appropriate boxes below. 1 r � A �No tax is due. 1 am#he spouse of the dec�ased or I em!he parer�'ofoa decekl�nt�ii�bs'was 21 years old or younger at date of death. � �, � Proceed to Step 2 on reverse. Do nat check any other box�&rrd r4ti�Kegi6�the�nt shown abave as Potential Tax Due. �, =y r � ;,y �-.� g �The informatipn is The above information is carrect, no deductions are being taken,��ytM�nt wiil be�t� , � correct. wfth my response. �" � � � -�rt _:, Proceed to Step 2 on reverse. Do nat check any other boxe��t C b � �+ o � � '": c, C �The tax rate is incorrect. � 4.5% I am a Iineal beneficiary(parent,child, grandchilp,et�of the decea�ed.Y" (Seleci correcf tax rate at -� s zn o ri ht, and com Iete Part o D � � 9 P � 12/o I am a sibling of the deceased. 3 on reverse.) � 15% All other ralationships (including none). p �Changes or deductions Tha information above is incorrect andiar debts and deductians were paid. ' listed. Compiete PaR 2 and part 3 as appropnafe on the back af this form. E �Asset will be reported on The above•idenGfied asset has been or will be raported and tau paid with thelPA Inheritance T� ioheritance tau form Retum fiied by tfie estate representative. , REV-1500. Proceed to Step 2 on reverse. Do nqt check any other bpxes. Please sign arrd date the back o#the forrrr when finished. �� PART Debts and Deductians z Allowable debts and deductions must meet both of the following criteria: A. The decede�t was Iegaily responsibie for payment,and lhe estate is insu�cient to pay the deduetible items. B. You paid the debts atker the death af the decedent and can fiurnish prqof ot payment if requested by the depaRment. pf additional space ie required,you may attach 8 1/2"x 11"sheets pf papec) Date Paid Payee Oescription Amount Paid Tptal Enter on Gne 5 of Tau Calculation $ PART Tax Calculatian 3 If ynu au's nt�l[�a carrectlQte tp i1MS ef�MkNthment dqi�R(41ne 1)accaunt kWu�(t�1ne 2),or percent t�tua4i�{Line 3), piears obi1��a�ctrRSaqen fmm die ftt�moii�t�aM�llon snd elEsah i#fa�nn. 1. Enter the dats the accaunt was established or Ystled as it existed at the date of death. 2. Enter the total balance of the account inctuding any interest accrued at the date of death, , 3. Enter the psrcentaee af U�e accpunt thai is taac�le to you. a. First,determine the percentage owned by the decedent. i, Accounts that are held in trust iar"another a athers wBre 100%owned by the decedent. ii. For joint accounts estaY�lished more than one year prior to the date of death,the percen[age taxab�e is 100%divided by the total number af owners including the decedent. {For example:2 owners=fiQ%,9 awners=33.33%,4 oWners =25%,etc.) b. Ne�,divide the deceder�t's parcantaqe rnmed by the number oi surviving owners ae beneficisries. 4. The amount subject to tax is daiermined by muNiplying the accouM bslance by tfie p�rcent taxabie. 5. Enter the total of any debts and deductions claimed from Part 2. 8. The amount taxable is determined by subVacUng the debts and deductions from Um amount subject ta tax. 7. Enter the appropriate tax rate frpm Step 1 based on your retationship to the decedent. It indicatin�a differant taz rate,please stata your relationship to ihe decatlent: 1. Da#e Established t 2. Account Batance 2 $ ' 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Detiuctiuns 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tau Due 8 $ 9. Wiih 5°k Discount{Taa�x,95) 9 x ' �$�i�: Sign and datte below. Retum TWO completes!ar�d si�ned cpple�s to the Repister of WAI�lis�d an ihe fr4nt ot tl�is form, along with a check for any payment you are making. Cfiecks must be made payabie to'Ragister of�Ns,AgeM." do not send payment directly to the Depertment of Revenue. Under penalry of perjury, I deelare that the facts I have reported abnve�re true,corcect and complete to the best of my knowledge and belief. WOrk _ Ho�e s" 7 S" � J � �� Taxpayer iga ture Telephone Number Da IF YOU NEED FURTNER ASSISTANCE, CONTACT F?E�YiYAN{A DEPARTlriFEMT OF F�EVEWt1E dISTRICT OFFICE, OR THE tNNER#TAidCE TAX DIVISIt3N AT 717-787-8327. SERV#GES F{3R TAXPAYERS WITH SPEGAL HEARING AND/OR SPEAKING NEEOS ONLY: 1-800-447-3020 COMMONWEFtTH Of PENNSYIVANiA REV-/1B2 EX{11-$BS OEPAflTMENT OF REVfNUE BUREAU OF INDIVIbUAL TAXE5 OEPT.180601 MAftRISBUflG,PA 1712&6801 PEIVRISYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT rva. ca o� 77ss RC}MBERGER MARY J 8109 SMITHFIE�d ST HARRISBURG, PA 1 71 1 2-3532 � ACN ASSESSMENT AMt}UNT GONTROL NUMBER --•----- Pola ____'..`__ ...__.__ 13123387 ( '5306.56 ESTATE lNFORMAT30N: SSN: 2t4-2&-5558 � FILE NUMBER: 2113-0085 � DECEDENT NAME: ROMBERGEF2 HANS S � DATEOFPAYMENT: 06/26/2013 � ' POS7MARK DATE: 06/25/2013 � CouNTY: CUMBERLAND ( DATE QF DEATH: O1/1 �/2013 � � TOTAI AIVIC}UNT PAI�: S30B.56 REMARKS: MARY J ROMBERGER CHECK# 636$ INITIALS: DB1 SEAL RECEIVED BY: GLENDA FARNER S7R/�SBAUGH REGISTER OF WILLS REGISTER OF WILLS ��. / � �� a w ° ` °w- v %^ � ^�', p � ... .,n . ��> u ,'--^.,.. .. � , , ..3 � � t`; �U ... 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