HomeMy WebLinkAbout07-22-13 _��� � x�=�=o�� T,�ES � enns tvania
p0 pOX Ya0607 Pennsylvania lnheritance Tayc P Y
NI�RRISlllRG PR I7128•0601 Infarmation Notice CIEPARTMENTOFREVENUE
PEV-SSti F%OeeEMEC{U-RS
And Taxpayer Response F��E NO.2113-0451
ACN 131374p5
DATE 07•OS-2013
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Estate of MARY�BOWERS� ° C_ vings
SSN � `� � . hecking
Date qf Death d4-10-2013 � r- ^�, , rust
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DAVID 6 BDWERS CountyCUMBERLAND r � r- � _ rtificate
52B W ELMWOOD AVE x" cn �� �, �_..
MECHANICSBURG PA 27055-4D24 -.� �,. ;�
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cir,�,�NS B�K aF rewNSr�vAxi,► pravided the department with ttre infarmafian beiow ind'+cating that at
the death of ttae above-narned decedent ou were a' ini owner or benefiiciary af the account identified.
Account No.8234474563 I�emit Paymetit and Forms to;
I DMe EBtdaNshsd 03^20^2012 REGISTER dF WILLS
Acaaunk Balance $y,534,7g Y COURTHOUSE SQUARE
PerceM Ta�cab�e X 50
CARIiSLE PA 17013
Amount SukHect to Ta3c $767.40
Tax Rate X 6.'i 50 NOTE': !f tax payments ara made wiihin three months of ihe
Potentiai Tau Due $t 15.11 decedent's date of death,deduct a 5 percent discouM on the ta�c
With 5'Yo Diecount(Tau x 4.85) �see NClTE*} due, Any inheritance tax due wifl become delinquent nine months
after the date ot death.
PAFiT .�t@p j: Please chec:lc the approprtate baxes beiow.
1
A [�P�te�c is due. i am the spouae of the deceased or t am the parent of a decederrt who was
21 years ald or younger at tlate af dea�.
Procena!ta Step 2 on reverse. Do not check ar+y other boxes and disrsgard the amaunf
shown above as Potential Tax Due.
g �The information is The above information is cortect,no deductions are being taken,and payment will 6e sent
carre,ct. with my response.
Procaed ta Step 2 ar+reverse. Do not check any aYher boxes.
C ❑The tax rate is incorrect. [� 4.5% I am a lineal beneflciary{parent,chiid,grandchild,ete.?of the deceased.
($elect correct tax rata at
right,and complete Part � �po� ���sibling of the deceased.
3 on reverse.)
� 15% All other relationships{including none),
p ❑Changes or deductions The information above is incorcect andfor debts and deductionswgr�paid. � �
iisted. Complete Part 2 and part 3 as appropriate on the back of thf&`fam.
E �Asset wiii be repoKed on The above-identified asset has been or will be reported and tax paid with the PA lnheritance 7a�c
inheritance tax form Retum fiied by the estate represeMative.
REV-!500. Proceed ta SYep 2 on revetse. Do rrat chech any ather boxes.
Piease sign and date tfia back of the farm when finished.
P"� Debts and Deductions
z
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 fumish proof of payment if requested by the department.
(If additional space is required,you may attach B 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Totai EMer on Line 5 of Tax Calculation $
PART Tax Calculation
3 H you are rtakfng a cortection to the establishmeM date(Line 1)account balance(Line 2),or percent taxable(Line 3),
ple�ss obtain a written correetion from tF�e financfal lnstitutionand 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 peroentage owned by the decedent.
i. Accounts that are held'in Vust 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=50Mo,3 owners=33.33%,4 owners
=25qo,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 ta�cable 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 tex 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 Tau 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Ta�c Rate 7 X
8. Tax Due 8 $
9. Wfth 5%Discount(Tax x .95) s X
Step 2: Sign and date below. Retum 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 Wilis,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.
G'�'C/.����1� S�� H e 717-691-7770
7—(�'.� /?
�ayer Signature Attorney for the Estate Telephone Number Date
of Mar F. B r
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