HomeMy WebLinkAbout07-17-13 (3) COMMONWEALTN OF PENNSVLVANIA REV-1 i62 EX{7 7-9$)
DEPAftFMEM OFflEVENUE
BUREAU OF INDIVIDl1AL TAXES
DEPT.280801
HAflR�38URG,FA t7t28-0fidt
PENN5YLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEtPT
NO. CD 017907
SNYDER WILUAM V
40 BRIARWOOD LANE
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CQNTROL
I NUMBER
-------� �a�4 ---_..__
13134301 � ( S773.48
ESTATE tNF4RMATiON: s5r�: � +
FILE NUMBER: z713-0686 �
oeCE�ENT NaMe: BOWLBY WILLARD F (
DATE QF PAYMENT: 07J19j2013 �
P4STMARK OATE: C}7(17(2013 �
CoUNrY: CUMBERLAND �
pATE QF DEATH: 06f 03j2073 (
I
TOTAL AMOUNT PAID: 5773.48
REMARKS: WILLIAM V SNYDER JR
CHECK# 1Q2
INITIALS: dB1
sea,� RECEIVED BY: GLENDA FARNER STRASBAUGH
REG{STER OF WILLS
REGISTBR OF WILL5
i
BUREpU OF INOIVSDIIAL „�FS Pennsyivania inheritance Tax � p��+��YEvania �������
Po BOX 2806a1 DEPARTMEN7 OF REVENIIE
HARRISBURG PA 17128-0601 Information Notice yEVas�e ax w�EVtc �ae-�xi
And T�payer Response Fi�E r�o.2� � l�� ��Cs
ACN 13134301
DATE 06-25-2013
Type of Account
Esiate of WILLARD BOWLBY Savings
SSN Checking
Date of Death 06-03-2013 Trust
LORETTA J SNYGER CountyCUMBERLAND X CeRifioate
70 6REENFIELQ DR
CARLIS�E PA 1?615-7b82
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MEMBERS isr Fcu pravided the department with the information below indicating that at the°t�eath of the
above-named decedent ou were a joint owner or beneficia of the account identified.
Account No.252582 Remft payment and Forms to:
Date Establfshed 09-15-2008 REGISTER OF WILLS
Account Balance $108,556.43 1 COURTHOUSE S(iUARE
Percen#Taxable X 16.667 CARLISIE PA t?013
Amount Subject to Tax $78,093.10
Tax Rate X 0.045 NOTE": If tax payments are made within three months of the
Potentiai Tau Due $874.18 deceslenYs date af death,deduct a 5 peroent discou�t on the tax
With 5%Discount(Ta�c x 0.95} �see NpTE') 'J?�7:+�$ due. Any inheritance tax due will became delinquent nine months
after the date of death.
PA� $rt@p 1: Ptease check the appropriate baxes belaw.
ti
A �IVo tax is due. i am the spouse oi tfie deceased or i am the parent af a decedent wha was
21 years aid ar yaunger at date of death.
Proceed to 5tep 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
g �The informatian is T he abave information is correct,no deductians ara being taken,and payment will be sent
correct. with my response,
Proceed to Step 2 on reverse. Dp not check any other boxes.
� ❑She tax rate is incorrect � A.5% t am a Iineai beneficiary{parent,chiid,grandchiid,etc.}of the deceased.
(Saieat corcect tax rate at
right,and complete Part � 12°/, I am a sibling of the deceased.
3 on reverse.)
� 15°Is AIk a#her relationships{induding none}. �
� ❑Cfiat�ges or deductions The infprmation above is incorrect and/or debts and deductions were paid.
iisted. Complefe AaR 2 and parf 9 as appropriate on ths back ot ihis fatm.
� �Asset will be reported on 7he above-identified asset has been or will be repprted and tax paid with the PA Inheritance Tax
inheritence t�form Fteturn fi{ed by the estate represenkative.
REV-1504. Proceed to SYep 2 on reverse. Do not che�k any aiher boxes. �
Please sign and date the back of the farm when finished.
PART Debts and Deductions
2
AAawable debts ar�d deduciions must meet both of the foilowing criteria:
A. The decedent was Iegaliy respansibie tor payrnent,and the estate is insufficient to pay the deductible items.
B. You paid the debts after#he death of the decedent and can furnish proof of payment if requested by the department.
{If additional space is required,you may atfach$1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Totai Errter on Line 5 af Tax Caiculatio� $
PART Tax Calculatian
3 if ya�sre msking a correatlon to tt�e establi�ment date{Line 1}accaurrt bai�ce{Uoe 2},or percent ta�ccabie{Une 3),
piease obtain a wriiten correcNon Nom tha Nnancial Instftution and attach it ta this farm.
1. Enter the date the account was established or titled as it existed at the date of death. j
2. Enter the total baiance of the accaunt including any iMerest accrued at the date of death. I
3. Enter the percentage of the account that is taxable to yau. !
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 estabiished more than one year prior ta the date of death,the percentage ta�cabie is 100�o dividad
by the to#aI numk�er ot owners including the decedent. {For example:2 owners=50°k,3 awners=33.33°ta,4 ovmers
=2$°/a�OtC.)
b. Next,divide the decedenYs percentage pwned by the number of surviving owners ar beneficiaries.
4, The amount subjec[ta tau is determined by muitipiying the account balarrce by the percent taxabfe.
5. Enter the totai af any debts and deductions olaimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
7. EMer the appropriate ta�c rate trom Step 7 based on ypur relationship to the decedent.
If indicating a different tax rete,please state
your relationship to the decedent:
1. Date Established 1
2. Account Baiance 2 $
3. Percent Tauable 3 x
4. Amourrt Subjeci to Tax 4 $
5. Debts and Deductions 5 -
8. Amount Taxable 6 �
7. Tax Rate 7 X
$. Tax due 8 $
9. With 5°/4 Discount (7au x .95) 9 X
�'it$�} 2: Sign and date below. ReWm iW0 completed and signed copies to the Register of Wiils listed on the ironk of this farm,
alang with a check for any payment you are making. Checks must be made payabte to"Register of Wilis,Agent° Do not send
payment directly to the Department of Revenue.
Under penaity af perjury, 1 declare that the facts i have repaRed above are true,correct and compiete to the best of my knowiedge and
belief.
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Taxpayer Signature Telephone Number Date
IF YOU NEED FURTHER ASStSTANCE, GQNTAGT PENNSY�VANIA DEPARTMENT OF F{EVENUE
DISTRICT OFFICE, OR THE INHERiTANCE TAX DiVIStON AT 717-787-8327. SERVICES FOR
TAXPAYERS WITM SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020
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