HomeMy WebLinkAbout07-01-13 '��° oF Z"°=YZ�,"� T"'�ES penns Ivania lnheritance Tax � enns tvanria
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HARRISBURG Pq i7128-06u1 Intormation Notice �EPARTMENT OF REVfiNUE
And Taxpayer Response "`°""°"°."„` "° °'
FILE NO.2t - ao►�-a���
ACN 13128513
Q�R�J�iJ ;J i�� !'..'F �� DATE 05-37-2013
R�GI"� i;:; OF ::�:,-�'r_�
' �, �(� 1 J� Type of Account
LI�l� ��1L
Estate Qf RALPH P JONES Savings
Cheaking
G L E R K G f Date of Deaih OS-15-2013 rn,st
JENNIFER J BATN p�PryqNS' COURT CountyCUMBERLAND Certificate
218 S70NEHED6E LN
necr+anicsauac aa��g�{�idD CG., P>�
� ceNrezc ��NK provided the department with the infarmation belaw indicating that at the death of the
above-named decedent ou were a 'aint owner or beneficiary of the account identified.
AccountNo.1099977
Remrt Payment and Farms to:
DetB Endlbiithed 04-34-20Q4 R OURTHOUSE SQUARE
Account Balance $4,077.45 CARLISLE PA 77d13
Percent Taxabie X 16.667
Amouni Subject to 7az $g7a.5g
�au Rate X 0.045 N4TE`: if tan paymer�ts are made within three morrths af the
�`�otentiai 7aa�CY�e $30.54 decedent's dats of death,deduot a 5 percent discount on the tax
L�l l With 5%�iscount(Tax x 0.95) $(see NOTE"} � � due. Any inhsritance tax due wil!become deiinquent nine monfhs
�� t after the date of death.
PAHT cvt@p 1: Please check the appropriate boxes b+elow.
1
A �1Vcs tax is due. i am the spouse of the deceased or I am the pareM of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 an reverse. Do not check any other troxes and disregard the amount
shown above as Potential Tax pue,
g �The information is The above information is correct, no deductions are being taken,and payment will kre sent
coRect. with my response.
Proceed to SYep 2 on reverse. Do not check any other bpxes.
c ❑The ta�c rate is incarrect. [� 4.5% i am a lineal beneficiary(parent, child,grandahild, etc.) of the deceased.
{Select cortect ta�c rate at
right,and compiete Part � ���, I am a sibling of the deceased.
3 on reverse.)
� 15% All qther relationships (including none).
Q ❑Changes or deduotions The informafion above is incorrect and(or debts and deductions were pa'rd.
Iisted. Comptete Part 2 and part 3 as appropriate on the back of this form.
E �Asaet will be repbrted on The above-identified asset has been or will be reported and tax paid wiih the PA tnheritance Tarc
inheritance t�farm Retum filed by the estete representative.
REV-1500. Proceed to Step 2 on reverse. Do npt check any other braxes.
Piease sign artd date the baak af the form when finished. `��
PA� Debts and Deductions
z
Albwabie debts and deduations must meet bath af the foilowing criteria:
A. The decedent was lagatly responsible far payment,and the estate is insufficient to pay the deduc#ible items.
8. You paid the debts after khe death af the decedent and can tumish proof of payment if requested hy the department.
Qf additional space is required,you may attach 81/2"x t t"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on�ine 5 of Taac Calculation $
P"�T TaX CaIGU{at�4n
3 tF yau are rriakinp a cocrectian to Nmr e�bti�tupani d�{Litia 1)accotNnt bN�nce{Line 2},ar percent taxsble{Lfne 3):
plsase obfeln a wrltten�rtectlon tram the Nnmcial Instltution snd attach k ta this form.
t. Enter the date the account was estabiished or titied as it existed at the date af death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. EMer the percentage of the accaunt that is t�abie to yoa
a. First,detarmine the percentage owned by ihe decedent.
i. Atxounts that are he(d"in trust fof anatMer a others were 1 QQ%owned by the deeedent.
ii. Far joint accounts more than one year prior to the date af death,the percentage taxabie is 7 00%divided
by the total number of owners inciuding the decedent. (For example:2 owners=509'0,3 cwir�trers m 33:83%,4 owners
=25°Ie,etc.j
b. Next,div�Ie the decedent'&pgrceni�e owned by the number of surviving owners or beneficiaries.
4. The amount subject to tau is detert�ried by muldplylr�g the account belan�by the percent iaxabie.
5. Enter tMe total of any debts and deductions claimed from Pert 2.
6. The amount[axable is determined by subVacting the debts and deducUons from the amaunt subject to tax.
7. Enter the appropriate tax rate from Step 1 based on your ralaGOnship#o the deeedent.
If indicating a d'rfferent taz rate,please state
your reiationship to the decedent:
1. Date Established 1
2. Account Baiance 2 $
3. Percent Taxabie 3 X
4. Amount Subject ta Ta}c 4 $
5. Debts and Deductions 5 -
6. Amount Taxabie 6 $
7. Tax Rate 7 X
8. Tax Due 8 $
9. With 5% Discount(Ta�c x .95) 9 X
�3�8�} 2: Sign and date bebw. F?eturn TWO compteted and signed copias to the Register of WUIs list�d on the frant of this form,
along with a check for any payment you are making. Checks must be made payable to"Register of 4WIIIs,Ay�ent" Do nat send
payment directiy to the 6epartment ofi Revenue.
Under penalty of perjury, !declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
Work
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Ta�cpayer Signature Tefephpne Number Qate
tF YOIJ NEED FURTNER ASStST/riN�CE, CC7NTACT PEI�IVSYLVANIA DEPAR'I'wIIENT OF REVENUE
DISTRICT OFFICE, OR THE INt+#ER(TANCE TAX DIVi3ION AT �17-787-8827, SER1/iGES FOR
TAXPAYERS WITH SPEGiAL HEARING ANQ/OR SPEAKING NEEdS ONLY: i-8d0-447 3020
COMMONWEALTH OF PENNSVLVANIA REV-1162 EX�11-98)
DEPAqTMENT OFREVENUE
BUHEAU OF INOIVIDUAI TAXES
DEPT.280801
HARRISBURG,PA 1]128-0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 017824
JONES VIRGINIA A
218 STONEHEDGELANE
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- �o�a
---------- -------
13128513 � 529.01
ESTATE INFORMATION: sSN: I
FILE NUMBER: 2113-0736 �
DECEDENT NAME: JONES RALPH P I
DATE OF PAYMENT: 07/O1/2013 I
POSTMARK DATE: 06/27/201 3 I
CoUN7Y: CUMBERLAND �
DATE OFDEATH: 05/15/2013 I
�
TOTAL AMOUNT PAID: 529.01
REMARKS: VIRGINIA JONES
CHECK# 3593
INITIALS: D61
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
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