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Home My WebLink About07-30-13 - COMMONVJEALTH OF PENNSYLVANIq REV-1182 EX�71-96) OEPARTMENT OFflEVENUE BUFEAU OF INOIVIDUAL TAXES DEPT.380801 HARPISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017957 MURPHY DENISE P 543 SPRING HOUSE ROAD CAMP HILL, PA 17011-1455 ACN ASSESSMENT AMOUNT . CONTROL NUMBER _.__.___ fob ___.__.__. ._.___._ 13127376 � S190.13 ESTATE INFORMATION: SSN: I FILE NUMBER: 2113-0821 I DECEDENT NAME: BROWN BETTY J I DATEOFPAYMENT: 07/30/2013 � POSTMARK DATE; 07(29(2Q13 � COUNTY: CUMBERLAND � DATE OF DEATH: 1 O/16/2012 I � TOTAL AMOUNT PAID: S190.13 REMARKS: CHECK# 460 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGFi . REGISTER OF WILLS REGISTER OF WILLS _ _ cZ 0Ud hau.e "�"D � �C(C Penny_� nia�lntierita�ic@rTax � �,� � . pennsylvania � �� C'��SfI11aYIlSI�"NOIICej _ - DEPARTMENTOFREVENl1E ��a- ,_And Taxpayer Response °F°'s^°Ex oo�ezec �oeaa �1�vi-�¢�,�{- ;!;','3 �UL 30 s'(TI 12 �z Acr�v "o.z�'� �-13-0821 `�,��fi� � DATE OS-23-2013 � v �L._.,n I bSf� �7�LlY (A.� o�;,�:�;:�� c��Ut71'. !%�idDERL{fd� r' � � � TypeofAccount Estate Of BETTYJ BROWN Savings SSN Checking Date of Death 10-16-2012 Trust DENISE P MURPHY CountyCUMBERLAND Certificate 543 SPRING HO�SE RD � CAMP HILL PA 17011-1455 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. Account No.536215377 Remit Payment and Forms to: Date Established 01-OS-2009 REGISTER OF WILLS Account Balance $2,535.12 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 1,267.56 Tax Rate X 0.150 Potential Ta�c Due $ 190.13 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 St@p 1 : Please check the appropriate boxes below. t A �No tax is due. 1 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. � �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��a 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 o/this/orm. , 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. 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 Calculation $ PART Tax Calculation . 3 If you are making a corcection to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the tinancial 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 da[e of death. 3. Enter[he percentage of the account that is taxable to you. a. First,determine the percen[age 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 decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is delermined 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 Ihe 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 rela[ionsnip to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X i2 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 $ � 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 torm, 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 DepaRment o(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. �� I� n work 31�1 -S�i2,o -�ly�,(�-L Y, rQ�,rt^X Home Taxpayer Signature Telephone Number Date -7��3 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. 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