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Home My WebLink About07-29-13 HUREAU OF INOSVIDUAL T�ces Penns Ivania lnheritance Tax .]� [�enns�/lvania PO 80% 280601 Y 1— J HARRISBURG PA 17128-0601 Information Notice �� DEPqRTMENTOFREVENUE And Taxpayer Response "�v.�su cr oe�crtc uear� ^^/,�/ FILE NO.21 �I , r 3- �o T ACN 13140298 DATE 07-24-2013 Type o(Account Estate of WILMER F MAYBERRY Savings SSN Checking Date of Death 06-17-2013 Trust JUDY A KENNEDY CountyCUMBERLAND �. Certificate 5 EASTWICK LN n CARLISLE PA 17015-7625 C w �7 rn � m m -�L. C_ � O � T C� '— U) � --i � �` D t' N �ri (Tt D � ; � A O ' O O C7 V �� ..r� 'I � �' -- C) . ;:J r-� �- :n • -- . _ - - . . . _ .. -. -;_. i- :y ��. ' c.0 O- - ' . _. ' U7 �T7 CI7IZENS BANK OF PENNSYLVANIA 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. Account No.61 0 0 688 26 6 Remit Payment and Forms to: Date Established 0930-1996 REGISTER OF WILLS Account Balance $6,216.25 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $3,108.13 Tax Rate X 0.150 Potential Tax Due g qgg.pp NOTE': If tax payments are made within three months of the decedenYs date of death,deduct a 5 percent discount on the lax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months afler the date of death. PART S�. 1 : Please check the a � � ppropriate boxes below. /+ No tax is due. I am the spouse of the deceased or 1 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 Tar Due. g �The information is The above informa[ion is correct, no deductions are being taken, and payment will be sent correct. with my response. P�oceed to Step 2 on reverse. Do not check any other boxes. � �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 � �p�, I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p dhanges or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and pan 3 as appropriate on the back of this lorm. E �Asset will be reported on The above-identified asset has been or will be reported and[ax 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. �/ 0 PART Debts and Deductions 2 Allowable debts and deductions must meet both of lhe 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 turnish 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 Calculalion $ PART Tax Calculation 3 �f 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 torm. 1. Enter the date the account was established or titled as it existed at the date oi 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 deceden[. 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[he decedent. (FOr example:2 owners=50%, 3 owners=33.33%,4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amou�t subject to tax is delermined by mul[iplying 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 irom 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 Official Use Only ❑aaF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD � 3. PercentTaxable 3 x �1 2 4. Amount Subject to Tax 4 $ 3 � 5. Debts and Deductions 5 - 4 ; 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ � I 8 9. With 5% Discount(Tax x .95) 9 X � St@p 2: Sign and date below. Return TWO completed and signed copies to the Regis[er of Wills listed on the front of this form, along wi[h 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 penalry of pery'ury, 1 declare that the facts I have reported above are true,correct and complete[o the best ot my knowledge and belief. Work Home Taxpayer Signature Telephone Number Date 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 JUDY A.KENNEDY 5 EASTWICK LANE CARLISLE,PA 17015 July 25, 2013 Re: Wilmer F. Mayberry Date of Death 6-17-2013 Cumberland County � Gentlemen: I received a notice from you stating that I owe inheritance tax on my father's checking account at Citizens Bank in Carlisle. This account belonged solely to my father. My name appeared on the account as a signer and POA at the time my father was admitted to a local nursing home. I have attached copies of the expenses that were paid out of his account for funeral expenses and nursing home expenses for the month of June. Aii of the monies were used to pay expenses with a balance of$208.90 to be used to engrave the tom6stone with the date of death. I don't believe we should be taxed as this money belonged to my father and was used to pay for his death expenses. Thank you for yo r time. ��C� , • Judy ennedy Daughterto Wilmer F. Mayberry Fune�ai Ezpense pai8 fo Ewing Brotfiers funeral Home........................................$4,757.26 Clergy Expense for funeral................................................................................................500.00 Sarah Todd Nursing Home expense for the month of 1une.................................... 1,150.09 Balance of checking account......$.6,216.25 Total of expenses........................ $6,007.35 Balance left for engraving $ 208.90 Please see attached. (O,/��L��/.� 7'�',iru�- 62f�P��L,��/-�/n�/� � STATEMENT Sarah ATodd Memorial Home 1000 W�t South Stree[ Stabement Dahe: 06/22/2013 Carlisle, PA 17013-2798 Due Date: p6/25/2013 Telephone: (71�245-2187 Amount Endosed $ ��,l� j Amount Due: $ 1,150.09 A000unt#: 101889 RE: WflmerF Mayberry Judy Kennedy 5 Eastwidc Lane Carlisfe, PA 17015 i' . � Dam-�,+� , ; :.; . >>: �--- � �' � -- - - - r��- -��- �.-- . .� . . ,6aWnces.�. larroe B/F ' 1,150.09 � 1,150.09 OS/23/13 NmY,IUDY 1,150.09 .00 OS/31/13 ble Televi�on 1 34.65 34.6 34.65 06/Ol/13 �ICME -1 104.9� -104.90 -7(1.?S 06/Ol/13 FMIIJODME 1,508. 1,438.27 06/01/13 rroe Premium Gedit -1 288.1 -288.1 1,150.09 � � WILMER F MAYgERRY JUDY:p �NEDK c�iAUS��8.43'illfJL'�� 944 . . ' � 3-761$/�5p PaY to the - � Q-J�/'�G�/� - zss . a erpf e - //.�r0 �9 �. - � Citizens Bank ��a`S � 8 �_ . _ � �zerrs Cirde qcawmt nnryiyania �• 36� 76 L 501� -��" ;��, 6 300888 26 n• 4 °° Currcrtt 31-60 Daps 61-90 Days AmouM Due 1,150.09 .00 .00 .00 1,1'5Q.09 � NOTE: �**�PAYMENT LS DUE UPON REG'EIF!e.es BIJi NO LATFA . -- - - THE 15M OP THE MONTH�*"^� qe�e remit tlre AMOUNT DUE your s�temenL Indude Me ACCTp from tlie 5tatement on the MEMO S�tement Dabe: 06/12/2013 af your�etic.vayrnents aRer 5�7/13 m rrot refiect on stapement, Due Dahe: p5/25/2013 NOTE: LATE DAYMENTS ARE SUd1ECT TO A 1.75%IATE WIRGE PER MONTH "A;30.00 FFE W!LL BE OIARGED fw REiIIRNED CHECKS ' Wilmer F Mayberry-Aaount#: 101889 Sarah A Todd Memorial Home 1000 West South Street Cadisle, PA 17013-2798 Teiephone: (71�245-2187 - - J {- �, ��'"` ��ing Brathers Fo�eral Home, Inc. �� 630 South Hanover Street Cazlisle,PA U013 �� (71�243-2421 June 25,2013 Judy A. Kennedy 5 Eastwick Lane Cazlisle, PA 17015 The Funeral Service for �✓��mer F.Mayberry We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOW[NG IS AN ITEMIZED STATEMENT OF THE SERVICES,FACILIT�S,AUTOMOTIVE EQUIPIvfENT,— � � � � - - � - AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Protessional Services Basic Services of PA L.F.D. 1,300.00 Bathing and Embalming 895.00 Other Preparation of Deceased 295.00 Basic Use of Facility � 200.00 Documentation Prep/Recording 325.00 FD/StaffSupervision ViewNisiUService 125.00 FD/Staff for Interment Service 125.00 Total Professional Services """'"""""g�'�'�p--° �quipment Hearse Usage 295.00 Safety/Lead Vehicte 135.00 Utiliry Vehicle 135.00 Total E ui ment """""'—""""' 9 P Sd5.00��-- Merchandise Cpr.Hammettone NG Casket 950.00 #l2 Regular OBC w.Setup 1,395.00 - Memorial Folders - - - 25.00 Total Merchandise Selected ' �2,�'9a.Q0 � AT THE TIME FUNERqL ARRANGEMENTS WERE MADE,WE ADVANCED CERTAIN PAYMHNTS TO OTHERS AS AN ACCOMMODATION. TI�FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. Cash Advances Cemetery Charges/Grave Open&Close 900.00 Rock breaking charge 687.50 The Sentinel Obituary 212.16 Death Certificates 30.00 Total Cash Advances . """°—'-'-"-j�g2f 6b---'- SALES TAX 0.00 �^''� ��) � SUB-TOTAL 6,029.66 / /� \ -�� / � INITIAL PAYMENT/DISCOUNT/CREDTTS 0.00 1 1� ��.��'JJJ�� %o gerEteiva U I� �� 1 v� TOTAL AMOUNT DUE 8.0�� _ C.��.�i CC�w�7�j Y 74'�-!Q K � �� 1 A� �J � - 707.Ya- yy�r r K H.+1L � �li9Ke � �� '7�d6 n 1 The unDe�d balance over 30 days is subjected to a 1 %service charge per month 12%per annum. _ C� �r� ,•� / ° ,.. . _—_ ..��...___...._... � _ _ _ _ � _ _ � ' < . < ,, � ,�` x -.J . - � . ' 4 ��RUED OFFICE OF � .�+,:;TEE2 OF !.'ILLS � =_ r � ,3 �!�t 2s �(1 i 1G ` _ :, �� c�cr,ic oF = , ,�,�. �, GRFNhNS' COURT = (��' +srCUMEiERLAND CO.. PA _ i �w � _ 13; _ �� , � _ . I� �` � = r � � l � � 4 � r[ (� , �-- (� �� \ �v �, � in � � � t4 � m iv � �r (�t 1 � './ r.7. �I � . . . ,H '� :� � 1 � \ II � � 1 �' i � r1 � 'L � �. � lv 1 � � , ��, I � 'V ^ I s�� • _� ',_�=,r� 4 �' ��V+I 1%� � G N� � V / �{ � � j