The URL can be used to link to this page

Home My WebLink About07-09-13 BUREAU OF INDIVIDUAL TAXES Penns �vania �nheritance Tax � pennsyLvania PO BOX 280601 y HARRISBURG PA 17128-0601 IC1fOrt7latIOC1 NOtICE ' DEPARTMENT OF REVENUE , r � �� REV-1543 EX DocEXEC COB-12) And Taxpayer Response FILE NO.21 °- � � �f ACN 13136484 �� DATE 07-01-2013 Type of Account Estate of NICHOLAS MELNICK Savings SSN Checking Date of Death 11-16-2012 Trust CHERYL D MELNICK County CUMBERLAND Certificate 52 CENTER DR CAMP HILL PA 17011-7611 ,.- :� � �_:� � t�� C � �`�� ` � � � --�; r--- GM,•�s ,�� , � M•-- C; .,, "� .�J �,:� 1�° � :�a; �"` � i°`"{ (� o�; ;� � ;:a � �� , �'-:� . O� ,� �`,� '.:; � � � � �m :�� _ — � � �, ...�. ::� � � y. ?..�i . ,•"' (�.-� - _ m k`. C� �a ^S (,�� 1 SOVEREIGN BANK 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. Remit Payment and Forms to: Account No.924025943 Date Established 11-10-1988 REGISTER OF WILLS Account Balance $�87,91 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subiect to Tax $293.96 Tax Rate X 0.150 Potential Tax Due $44.09 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 months after the date o#death. PART ep 1 : Please check the appropriate bo�ces below. � A No tax is due. I am the spouse of the dee�ased flr I am the parent af a decedent who was 21 years old or yaunger at date of death. Proceed to Step 2 on reversE. Do not check any other boxes and disregard the amount s/�own above as�'otentia/Tax D�e. g �The in#ormation is The above information is-correct, no deductions are being taken, and pa�yrrtent 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 a lineal beneficiary(parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part � 12% 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 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 Deduc�ians 2 Allawable debts and deductions must meet both af the fiallawing criteria: A. The decedent was legally respansible for payment,and the estate is insufficient ta 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 8 1 J2"x 11"sheets o�paper.) C}ate Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation _ 3 )f you are making a carrection#o the establishment date(Line 1)account balance(Line 2},ar percent taxable(Line 3), please obtain a written correction firom the financia!institution and attach it to this form. 1. Enter the date the account was established or titfed as it existed at the date of death. 2. Enter the total balance 4f the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable ta you. a. First,determine the percentage o�uned by the decedent. i. Accounts that are held"in trust for"anotner or others were 100%owned by the decedent. ii. For joint accaunts established more than one year priar to the date of death,the pereentage taxabie is 100%divided by the total number of owners including the decedent. (Far example:2 owners=504�p�3 owners=33.33°/a,4 owners =2rJ%, 2tC.� b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The arnount subject to tax is dei�rmined by multiplyinC the account balance by the percent taxable. 5. Enter the total of any debts and deductiu��ciaimed 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 Ste�1 based on yo�r reEationship to the decedent. !f indicating a different tax rate, please state � �� : � � � � your relationship to the decedent: � ' ��#��I'�"t��#��1��'t�� 1. Ga#e Established 1 � ;; ;� � � ; � , , � � 2. Account Balance 2 $ �'��; ; � �� ' � � � 3. Percent Taxable 3 X � 4. Amount�ubject to Tax 4 $ � 5. Debts and Deductions 5 - �� °, ��; 6. Amaunt Taxable 6 $ � ?. Tax Rate 7 X � � . 8. Tax Due 8 $ � � � . � �9. With 5°lo Diseaunt(Tax x .95} 9 X � � � �� . . .._. _ . _ . ._....,._ . . ... sfGp �: Sign and date below. Return TWO compieted and signed copies to the Register of Wills listed on the front of this fiorm, along with a check for any payment yau are makinc�. Checks must be made payable to"Regi�ter of Wills, Agent." D�not send payment directiy to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete ta the best of my knawledge and belief. �� . "?,�`� Work��'�;"-�.��1!3 ,►.� ,:��G�-,' l�' :-N�� . r Home � - � �� 7 �� r` axpayer gnature Telephone Number�'�-��'`� ,a _,�„ Date ,�-� c c,�....� � /.� IF YOU NEED FURTHER ASSISTANCE, CC)I�TACT PENNSYLVANIA DEPARTMENT OF R ENUE QI�TRICT OFFI�E, C.�R THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FC}R TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020