HomeMy WebLinkAbout07-16-13 (2) ���� a� �xorY=�,� ��ES '�i�/ pennsylvania
P4 60X 280601 Pennsylvania lnheritance Tax
HARRISBIIR6 PA 173Y8-D6U2 information Notice �„ �EpApTMENTOFREVENUE
And 7axpayer Response "` ,s"E'�""" "' "'
Fi��Na.�,��-os�a
- ACN i3i12690
DATE 03-15-2013
RE�,lS'E�k 4F `:q';:»i,a
Type of Account
t��3 ���_ �� ��i`� �, i ,�state of SUSAN R HAMMEL �Savings
SSN Checking
Date af Death 08-08-2411 Trust
dRIN H SENJAMIN �LERK 0', CountyCUMBERLAND Certificate
CARLISLEUPp 17013-2829 Q�pHANS� ��}�1��
GUMSERLAND GC?.. P,'1,
� CURNERSTUNE Fcu provided Yhe department with the information befow indicating that at the death of the
above-nameci decedent you were a joint awner or benefici of the account identified.
Remit Payment and Forms to:
Account No.826453001
Date F�tabliahe�!06-06-2Qt t REGISTER OF WILLS
Account Balance $0.00 1 COURTHOUSE S4UARE
Percen[Taxable X 100 CARUSLE PA 17013
Amourrt Subject to Tvc $0.�0
Taac Rate X D.045 N�TE': if tax payments are made within three months of the
Potential Ta�c Que $0.00 decedenYS date of death,deduc[a 5 petcent discount on the ta�c
With 5°/n Discaun[(Tau x 0.85) $(see NOTE`i due. Any inheritance tax due will become delinque�t nine monYhs
after the date of death.
FAftT gtep 1: Please check the appropriate boxes beiaw.
7
A �Na tax is due. I am the spouse ofi the deceased or 1 am!he parent af a d+ecedent who was
21 years o!d or younger at date of death.
Praceed to Step 2 on reverse, Do nof check a�y other boxes and disregart!the amaunt
shawn above as Potential Tar due.
g �The f�formatian is The above informatlon is correct,no deductions are being Yaken,arfd payment wi8 be sant
carrect. with my response.
Pmc��ed to Step 2 on reverse. Da nof check any other boxes.
� ❑The fa�e rate is ineorrect. � d.5°lo I am a fineai beneficiary(parent,chiid,grandchild,etc.)at the deceased.
{Select comect tau rate at
right,and compiete Part � �2q, I am a sibling of the deceased.
3 on reverse.)
� 15°lo A��other relatianships{including none).
p ❑Changes ar deductions Tha information abave is iricorreci andtar debts and deductions were paid.
lisfed. Comptete Part 2 a»d part 3 as appmpdate on the back of fhis form.
� �Asset wiii be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritanee Ta�c
inheritance ta�c form Retum filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do nni check any oMer toxes.
Piease sign and date the back of the form when finished. \"1i')"
��_
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 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 Calcula[ion $
PART Tax Calculation
3 If you are msking a correction to the establishment date(Line 1)account balance(Lfne 2),or peroent taxable(Line 3),
please obtafn a wdtten correction}rom the financial instkution 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 tauable 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. Ne#,divide the decedent's 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 retationship 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 Ihis 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.
� � Wofk
L21�1 b ryt��1 Home 7/1 2Q�' 64 3'{ T/�,-3
Taxpayer Signature� Telephone Number Date
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
O�1LY: 1-800-447-3020