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Home My WebLink About07-01-13 _ . �� BUREAU OF INDIVIDU/4L TAXES Penns Ivania lnheritance Tax � pennsyLvania PO BOX 2806D1 y HARRISBURG PA 17126-0601 Information Notice DEPARTMENT OF REVENUE REV-1543 E%DocEXE[ (OB-12) � And Taxpayer Response FILE NO.21�' �_3 '�-'��`� ACN 13134615 DA7E 06-25-2013 ��;�,.� �� ;�, � ��: �r- R�:�;�'a � ;v;t �ir �:';'!_{_.S Type of Account Estate of MARTHA L SLOTHOWER Savings,l �t� Checkit� ::�?i 3 ��. tl �� 2 �of Death 11-05-2012 Trust � GERALD L SLOTHOWER I County CUMBERLAND X Certificartle 532 MOUNTAIN RD �L�iy� �j : ' DILLSBURG PA 17019-1520 ORP�ANI5' C�'�1RT CUMBERL,�ND C�J., PA SOVEREIGN BANK provided the department w!ith the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.1685549725 Date Established 11-13-2009 REGISTER OF WILLS Account Balance $5,005.20 ' 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $2,502.60 Tax Rate X 0.150 Potential Tax Due $375.39 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(Tax x 0.95) $(see NOTE*) due. Any inheritance tax due will become delinquent nine montF�s' � after the date of death. PART Step 1 : Please check the appropri�te boxes below. 1 A �No tax is due. I am the spouse �f the deceased or 1 am the parent of a decedent who wa$ 21 years old or y�ounger at date of death. Proceed to Step 2 on reverse. Do not check ar�y 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 not check any other boxes. C �The tax rate is incorrect. � 4.5% I aml a lineal beneficiary(parent,child, grandchild, etc.)of the deceased. (Select correct tax rate at right,and complete Part � �2% I am a sibling of the deceased. 3 on reverse.) � 15% All o�her relationships (including none). � p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Par1 and part 3 as apprapriate on the back of this form. � E �Asset will be reported on The above-identified a�set has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Retum filed by the esta�te representative. REV-1500. Proceed to Step 1,2 on rever5e. Do not check any other boxes. ��Y Please sign and date the back of the form when finished. - - - - _ i - - - �. _ _ 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. (ff additional space is required,you may attach 8 i/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation $ PAR7 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 incl�ding 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 multiplying the account balance by the percent taxabte. 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,please state your relationship to the decedent: 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 8. Tax Due 8 � 9. With 5%Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wil�s 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 Wills,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 Home - - /� Taxpayer Signature Telephone Number ate IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRlCT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 � _�.�, _ BUREAU oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � DennsvLvania PU BOX 280601 y r J - HARRISBURG PA 17128-0601 Information Notice DEPARTMENTOFREVENUE And Taxpayer Response REV-1543 E%DocE%EL (OB-12) FILE NO.21 ACN 13134614 ��(�t;?:; ; �;;' , ,,~;- �� DATE 06-25-2013 ��~��.�1., y..ii VII� ..'f?..�..a :��1 L3 ��i_ 1 �� Q� Type of Account ' state of MARTHA L SLOTHOWER Savings! �� SSN Checking� �L Y�f(E� �; Date of Death 11-05-2012 Trust GERALD L SLOTHOWER O�p��J ��,��n�• CountyCUMBERLAND X Certifica�,e 532 MOUNTAIN RD DILLSBURG PA i�oi9-is2oCUMBERLAP��t i'�., 0�1� SOVEREIGN BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint own�r or beneficiary of the account identified. Account No. 1685549709 Remit Payment and Forms to: Date Established 11-13-2009 REGISTER OF WILLS Account Balance $10,010.39 ' 1 COURTHOUSE S�UARE Percent Taxable X 50 � CARLfSLE PA 17013 Amount Subject to Tax $5,005.20 Tax Rate X 0.150 ' Potential Tax Due $750.78 NOTE*: If tax payments are made within three months of the ' With 5% Discount Tax x 0.95 decedenYs date of death,deduct a 5 percent discount on the tax ', � ) _$�see NOTE') � due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropria�te boxes below. 1 A �No tax is due. I am#he 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 correct. 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�lineal beneficiary(parent,child,grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12��, I am�sibling of the deceased. 3 on reverse.) � 15% All otF�er relationships (including none). p �Changes or deductions 7he information above i incorrect and/or debts and deductions were paid. listed. Complete Part 2�and part 3 as approprrate on the back of this form. � E �Asset will be reported on The above-identified as�et has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estat�representative. REV-1500. Proceed to Step 2�on�everse. Do not check any ofher boxes. a Please sign and date the back of the form when finished. �� i , _ � �- 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 addifional 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 Tax Calculation $ PART T1X CaICUIc�tI0C1 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 tauable 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 multiplying 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, please state your relationship to the decedent: 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 8. Tax Due 8 $ 9. With 5% Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register af Wills listed on the tront of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I decfare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. Work Home / - - 9� � �7 Taxpayer Signature Telephone Number Dat IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 z �� .y�..S.;�t� i :! ��: "'� �� : � �� : .a "+�.:�'+r . 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