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Home My WebLink About07-10-13 (2) . , �,. . ,_,.� _ ,. ma_,� .�:� ��. —_ _ �� ,- �,� . . , .�� _ . BUREAU OF INDIVIDUAL TAXES Penn�y�vania lnheritance Tax � � � Per11'1S�/LVarlla PO BOX 280601 DEPARTMENT OFREVENUE HARRISBURG PA ��z6-o6o� Information Notice REV-1543 EX DocE%EC (OB-12) And Taxpayer Response FILE NO.2113-0545 ACN 13128811 DATE 05-29-2013 9�� ;`; : , ir'i � Type of Account ��; � , ,:�'�� ^ �'�E's#�te of PATRICIA A HARRIGER Savings i�';i v';;,.. ,.� , i � 1 �SS'I�t 362-44-4636 X Checking Date of Death 04-12-2013 Trust JEFFREY ASMITH (��';�;:?�, :.. , CountyCUMBERLAND Certificate 1 VISTA DR , -: NEW CUMBERLND PA 17070-2729�i��`��j�� '�'" � CUt�3�RL�':E,;r; i:<�:° , �'°�°� METRO 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.513248260 Date Established 09-14-2001 REGISTER OF WILLS Account Balance $29,312.09 1 COURTHOUSE S(�UARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $14,656.05 Tax Rate X 0.150 Potential Tax Due $2,198.41 NOTE*: If tax payments are made within three months of the decedenYs 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 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 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. Comp/ete 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. P"RT 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 additional 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 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 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 of Wills 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 Ql Home Taxpayer Signature Telephone Number �� -�-��_v��y�Date f� � .� IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ON LY: 1-800-447-3020 BUREAU OF INDIYIDUAL TAXES Pennsylvania lnheritance T� � pennsylvania PO BoX 28oboi OEPARTMENT OF REVENUE NARRISBURG PA 17126—q601 Information Notice And Taxpayer Response REV4543 ex m�Exec coe-iz� FI�E NO.2113-0545 ACN 13128812 DATE 05-29-2013 Type of Account Estate of PATRICIA A HARRIGER Savings SSN 362-44-4636 X Ghecking Date of Death Q4-12-2p13 Trust JEFFREY ASMITH County CUMBERLAND Certifica:te 1 VISTA DR NEW CUMBERLhID PA 17070-2729 C'� - C � �`' �.:� _. �i-� e �._� _ . .. ,',:� _ E,.� = � � �� '. � �� s . .�.. _ . , �-, ... ...., ,_, ., �,_ _.. _°,, � .-.�3 � _ _ METRO BAIVK pravided the department with the informatian belaw indicating that,�at the c�th o�the above-named decedent you were a joint owner or beneficiary of the account"�len�ified. _�- _ , Account No.2840009373 Remit Paymen#and Forms to: Date Es#abGshed 08-03-2011 REGISTER OF WILI.S Account Balance $2,002.32 1 COURTHOUSE SGIUARE Percent Taxable X 50 CARLIS�E FA 17Q13 Amount Subject to Tax $1,001.16 Tax Rate X 0.150 �p-�E": If ta�c payments are made within three manths of the Potential Tax Due $150.17 decedenYs date of death,deduct a 5 percent discount on the tax With 5°lo Discount{Tax x 0.95} ${see Nt3TE*} due. Any inheri#ance tax due will becoms delinquent nine months after the date of death. P;RT StGp 1 : Please check the appropriate boxes belaw. A �No tax is due. I am the spouse of the deceased or I am the parent af a decedent who was 21 years ald or younger at date of death. Proceed to S#ep 2 on reverse. Do not check any other boxes and disregard the amount � shown above as Potential Tax Due. g u The inforrr�ation is The abave infarmatian is correci, na deductions are being taken,and payment will be sent correct. with my response. Proceed f�Sfep 2 on reverse. Do not check any afher boxes. C �The tax rate is incorrect. � 4.5°/Q I am a lineal beneficiary(parent,child,grandchild,etc.}af the deceased. {Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.� � 15°lo All ather relationships(including none}. p �Changes or deductions The infarmation above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back of this form. E '�Asset will be reparted on The abave-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance t�farm Return filed by the estate representative. REV-1500. C'roceed to Step 2 on reverse. Do not check any ather boxes. Please sign and date the back of the form when finished. PaRT Debts and Deductions 2 Aliowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible far payment,and the estate+s 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,yau may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter an �ine 5 of Tax Calculation} $ PART Tax Calculation 3 If you are making a correctian to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please abtain a written correction from the financial institutian and attach it ta this form. 1. Enter the date the account was established or tit#ed as it existed at the date of death. 2. Enter the tatal balance af the account including any interest accrued at the date of death. 3. Enter the percentage af the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accaunts that are held"in trust for"another ar others were 100°l0 owned by the decedent. ii. Far joint accounts established more than ane year prior to the date of death,the percentage ta3cable is 100%divided by the tata!number of owners including the decedent. (For example:2 owners=50%,3 awners=33.33°!0,4 owners =25°la,etc.} b. Next, divide the decedenYs percentage awned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxabie. 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 arnount subject to tax. 7. Enter the appropriate t�rate from Step 1 based on yaur relatianship to the decedent. lf indicating a different t�rate,please state �°'�'`� �«� �' " :"` ' �� your relationship to the decedent; �� 1. Date Established 1 2. Account Salance 2 $ � 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ `` �� *�.� ��c � � 5. Debts and Deductions 5 - * ' � � 8. Amnunt Taxable 6 � � ° �� 7. Tax Rate 7 X `�x� .�.. ,�� ,..... _ �_ . . ��.�;. 8. T� Due 8 $ � 9. With 5%Discount{Ta7t x.55} 9 X ��.\� '��' � � �� V � � � � S��'p 2: Sign and date belaw. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payabie to"Register of Wills,Agent." Da nat send payment directiy to the Department of Revenue. Under penalty of perjury, 1 declare that the facts 1 have reparted above are trus,carrect and complete to"the best of my knowEedge and belief. 1Nork � ,� Home Taxpayer Signature Telephr�ne Number �� Qate ,� �� IF Y{JU NEED FURTHER ASSISTANCE, CONTACT CUMBER�AND COUNTY REGISTER 4F WILLS, PA DEPARTMENT OF REVENUE DISTRICT QFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FQR TAXPAYERS WITH SPECIAL HEARING AND/4R SPEAKING NEEDS ON LY: 1-800-447-3Q20