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Home My WebLink About07-05-13 ' BUREAU OF INOIVIOURL rnues Pennsylvania lnheritance Tax �:�j Pennsylvania �► , Pa BOX 280601 DEPARTMENTOFREVENUE IWRRISBURG PA 17128-0601 Information Notice aev-�sas[a ue�exec ioe-�z� And Taxpayer Response FILE NO.21 ��—�75� ACN 13130645 �� r DATE 06-25-2013 �r^,:,'S : ;_:: u'r 4'�ILL� Type of Account 1. ��,i;3 ,i;j�_ 5 P�l 1= i7 Estate of HELEN SCHARDIN Savings SSN Checking C�E RK C Date of Death 05-23-2013 Trust BARBARA S nnWSON County CUMBERLAND Certificate 3805 PAMAY DR C)i;i'HANS� ,�...;'..��-;�: : MECHANICSBURG PA 170��LA��: '� ��. . "�� , MEMBERS isr Fcu provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficia of the account identified. Remk Payment and Forms to: AccountNO.235793 Date Established 09-24-2003 REGISTER OF WILLS Account Balance $4,037.92 1 COURTHOUSE S(�UARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $2,018.96 Tax Rate X 0.045 NOTE': If tax payments are made within three months of the Potential Tau Due $90.85 decedenYs date of death,deduct a 5 peroent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months aRer the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the 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 2verse. Do not 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 � �2=�o I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(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 inheri[ance tau form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. ^ � l-T 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 following criteria: A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductiWe items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is raquired,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 Tax Galculation 3 If you ars mskinq a corrsctia�W ths atqbllshmeM dNe(Une 1)sccount b�lance(Llne 2),or percent taxable(Line 3), _ plaaae obrtain a xrcNten correotlon from the flrronclei institutlon a�d at#ach R to thts fo'm. 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[hat is taxable to you. a. First,determirre the percentege owned by the decedent. i. Accounts that are heW"in trnst for"anMher or others were 100°/,owned by the decedent. ii. For joint accounts estabiiehed more than one year prior to the date of death,ihe percentage ta�cable is 100%divided by the total number o1 owners including the decedent. (For exampie:2 owners=50%, 3 owners=33.33%,4 owners =25%,etc.) b. Next,divide the decedent's perceMage owned by the number of surviving owners or beneficiaries. 4. Ths amount subject to tau is de[ermined 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 subhacting the debts and deduc[ions from the amount subject to[ax. 7. Enter the epprop�iate ta�c rafe from Step t based on your relationship to the decedgnt. If indicating a diiSerant tax r�ate,please state your relationship to the debedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percen[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 �J' t@p Z: Sign and date below. Retum TWO complated and signed copies ro the Register of Wil�listed on the front of this form, along wdh 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 penalry 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 �7i71 ��'�9�f T�Q,+.�i� � � .��uq.�� Ho„� ��,T_�a� -g��t� l.� ��/ao�3 Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVAN{A 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 �,�� w, ; �, , ,4 � ; � ;,�' , �. i . 1 ! � ��cofn�� r�� , ,' s � �'F�� : �� F�CE OF 'y � �j� C: ;J �i;1 � ' �, � �� IS i _ � �� , � '; 5 . (712 ,, � y 7 �. �r � ' g�i � ' 0,',, � ��"fi f.'r' � '^'NAT�S' Ln .r � !� �" GUMBERCAPy'r enr , Pq � x�,, : ` �� '' ,, ; r_, ;:,, � i.i � . ��h :"" -. '� y� �+j � S�: �yy � � ' � � �' � _ �. � � � 1r , �a a e� � � m a � � �'� r � � � a t7 ; � w (� � f"' � y~ � U � �r w. � � 0 � � ' � a c °pp N � G � � v _ E ._ `�°'a m ' � � u w m m � ' i 'i . '1. .; tW,4.. ..! . ,� . ,,..�;.Y�* . .. :�� r �.<st �.,.-*b � �# ,d3:, cz�x 'k; �°�d„�,{�1. zr t�" "� 'i ��A � � � � �� t � � �`�Ay" t r�. � � a :' * � ; ��, _ �,f +t �. r �+,n . r,� c ; , � r, �` .. _,t-'+. ' "� �. � � " _ _ _ , _ _ • BU2EAU OF INDIVIOWL TAXES Penns Ivania lnheritance Tax � [�enns�/lvania PO !OX 280601 Y f J WIRRISBURG PA 17128-0601 Information Notice DEPARTMENTOFREVENUE And Taxpayer Response °`°""'"°°""` `°• °' FILE N0.21 /,3—�7�� ACN 13130646 r i f i "'`I^i" DATE 06-25-2013 RE�IS7::iZ Or 1', ,'_'.S Type of Account jU13 J��_ S ��I� 1� �8 Estate of HELEN SCHARDIN Savings SSN Checking BARBARA S DAWSON CLERK Qr c un�fCUMBERLAND13 Trust 3805 PAMAY DR ORPHANS� ��UR� ry X Certiticate MECHANICSBURG PA i�o�g�LAND CO., PA MEMBERS isr Fcu provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.235793 Remit Payment and Forms to: Date Established 0&242003 REGISTER OF WILLS Account Balance $1,152.55 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $57628 Tax Rate X 0.045 Potential Tax Due $25.93 NOTE': If tax payments are made within three months of the With 5%Discount Tax z 0.95 decedent's date of death,deduct a 5 peroent 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 appropriate boxes below. � A �No tax is due. I am the 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. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grandchild,etc.) of the deceased. (Select correct tau rate at right, and complete Part � �p=�, I am a sibling of the deceased. 3 on reverse.) � 15°/, All other relationships (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 o/this lorm. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax 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 deb[s and deductions must meet both of the following cri[eria: 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 additional space is required,you may attach 81/2"x 11"sheets of paper.) Date Paid Payee Description Amou�t Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are mdclll�a cortestion to da aqq�ishmsnt dlNe-(Line 1)account b�lance(Line 2),or percent tax�le(Line 3), please obtaln a willten corroctlon 1rom ihe flnenClal InMlhtdon and aMach R 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 e�e�lished more than wre year prior to the date of death,the percentage tauable is 100%divided by the total number of owners including Me decedent. (For exampie:2 owners=50%, 3 owners=33.33%,4 owners =25%,etc.) b. NeM,divide the deced6rrt's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject ro tax is determined by muftiplying the account balance by the percent tauable. 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 appropriateAta3c rate from Step 1 based on your relationship to the decedent. If indicaCing a diffgrent tax rate,please state your relationship to the iiecedent: 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 S#ep.2: Sign and date below. Retum TWO co�leisd and signed copies to the Repister of WNIs liated on the front of[his form, along wdh a check for any payment you are making. Checks must be made payable to"Register of�Ils,Agent" Do not send payment directly to the Department of Revenue. Under penalry of pery'ury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. WOfk (7/7) �/�/- �S �{9� ��„r,�„� ,A ��..,�.�.� Mome (7i�) �{al- Ay9� G��l�o�_� Taxpayer Signature Telephone Number Date 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 _.. _... ..�n C. `y,.� REC��rE� ; n � ; . �� o, � n u� , , ;.:� f�E�sIJ ! c t '�'� ? 'B � ;ii13 JUI. 5 Fi'1 i `� - , � � �,� CLERK Or _ � ORPtIAN5' CGURT ; �a ' � � P CUMBERLANU uq., PA = .s � � ,�� _ � f', qi � , � � ,,, �t' - � ', = � r. .. -. ... - - � � �": ; 1 : d S �„�: _ M • � � 0 � � � � � � a a a �� _ � � � � m �,. � � � � � � �, v a 0 � Q d . m N O � � � � D O � '� o� 9 � d m � � __.. ..._._.._ - ,, � Y �: < R-" � f. ��[ M` � � � .� �. �� x:, � 5 : { � )�,�£s� c A� � :_ Y kk� ,p,f F f 6 { g� M � �: } y � — v� ^'T?�."'°�"*__""..'!°q^i^�sn`'. v's�y�°`1R�'(ni.': . ... . _ ___ - e BURFAU OF INOIVIOWL TpXES Penns Ivania inheritance Tax � DennsVlvania PO !OX 280601 Y • + HARRISlURG PA 1�128-06a1 Information Notice DEPARTMENTOFREVENIIE vev-isaa ex oe=exEC �oa-in And Taxpayer Response Fi�E No.2r-/3-�7$"/ ACN 13130647 DATE 06-25-2013 � r�DED �1r�� , �ISTER t�i 1 TypeofAccount _ � Jut' � n� Estqtg of HELEN SCHARDIN Savings SSN. Checking Date of Death 05-23-2�13 Trust BARBARA S DAWSON �L��K a� CountyCUMBERLAND Certificate 3805 PAMAY DR MECHANICSBURG PA 17050-7675 OR�'t�ilaN$� ��.. CU6��ERt_AND C MEMBERS isr Fcu provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.235793 Remit Payment and Forms to: Date Eatablished 03•�2-2007 REGISTER OF WILLS Account Balance $ 1,�qp.5p 1 COURTFIOUSE 3(iUARE Percent Taxable X 50 CARLISLE PA 17073 Amount Subject to Ta�c $57126 Tax Rate X 0.045 NOTE': If tax a ments are made within three moMhs of the Potential Tax Due $25.71 P y decedenYS date of death, deduct a 5 percent discount on the[ax With 5°/, Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months af[er the date ot death. PAR7 Step 1 : Please check the appropriate boxes below. � A �No tax is due. 1 am the spouse of the deceased or 1 am the parent of a decedent who was 27 years old or younger at date of death. Proceed to Step 2 on 2verse. Do not check any other boxes and disregard the amount shown above as Potential Tar 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. � ❑The tau 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 � �pry, I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (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 o�this lorm. E �Asse[will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Taac inheritance tax torm Return filed by the estate representative. REV-1500. Proceed to Step 2 on 2verse. 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 deduMions must meet both of the following criteria: A. The decedent was legaliy responsible for payment, and the estate is insufficient to pay the deductiWe items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.} Date Paid Payee Description Amount Paid Totai Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are nwking a correctlon to the estaWlshmant tlate(Line 1)accquM balpnce(Line 2),or percent texd�e(Line 3), ,_ please obfaln a wrltMn eort�ectlon irom ll�e Anancial Instltutlon and rttsoh k to this torm. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total baiance of[he account including any interest accrued at Me date of death. 3. Enter the percentage of the account that is taxable[o you. a. First,determine the percentage owned by the decedent. i. Accounis that are held"in trust for"another a others were 100�0 owned by the decedent. ii. For joint accounts astablished more than one year prior to the date of death,the percentage taxable is 100°/,divided by the total number of owners inciuding the decedent. (For example:2 owners=50%,3 owners=33.33°k,4 awners =25%,etc.) b. Next, divide the decedertYs 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 ta�cable. 5. Enter the total of any debts and deductions daimed hom Part 2. 6. The amount taxable is determined by subtracGng the debts and deductions hom the amount subject to tau. 7, Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If irtdicating a diffarent tac rata,please stafe your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. PercentTaxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. AmountTaxable 6 � 7. Tax Rate 7 X 8. Tar Due S � 9. With 5% Discoun[(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Registar of WiIIs Gsted on the fiont of this fam, afong with a check for any payment you are making. Checks must be made payaWe to"Register of Wilis,Agent" Do�ot 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 �7� 7 ) 41a � - $y9�/ �Q.r/a g-�t � ,� .�LLur�.o� Homs�7��) 4�0�/- FS�f9 `� (P/a7�ao�3 Taxpayer Signature Telephone Number Date i� YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTM�NT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DlVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 �� J��;�� RE[C' Ofbti l �Jf �w�C �"-F _ 4, � {�I.LIJ � L\ VY P l� J ��J � � �. � p _ � � �, �� :.'ii� JU�_ � ;�I i i� �ip � k I ' 1� ` CLERY C�' — ; �, ORPNANu' Ct`!.,RT - ; ; CUMBERLAND CO., PA = � _ � — ` ' � _ .Y F., � � r W � ., , � � �l � rl +. O � � (p � - w� ,� a � ; o < � � � �, �� {'i� � ^ 'M � W rl (� 0 � f O ' N O ! r � Q a o � �° N � � � E �0 c � a r d � u � � W m M �