HomeMy WebLinkAbout08-01-13 (2) BURFAU OF INDIVIOUqL TAXES Penns Ivania lnheritance Tax � enns lvania
PO BO]f 280601 Y P Y
NaRRISBURG Pp 1 7128-06 01 Information Notice DEPARTMENTOFREVENUE
And Taxpayer Response "`��"°"�""` "°",
- FILE NO.21-13-Og�jS
ACN 13135977
C 0 f DATE 06-28-2013
REGISTER Or' WlLLS
t��3 Fi�� 1 Q� � �� Type of Account
tat NANCY R DONLEY Savings
SSN Checking
CLERK OFGDateofDeath06-14-2013 Tn,st
24SKENSINGTON SO ORPHANS� ��Ue�tyCUMBERLAND CertifiCate
MECHANICSBURG PA 17050-2364 CUI+EBERLAND CA., PA
MEMBERS isr Fcu provided the department with the information below indicating that at the death of the
above-named decedent ou were a joint owner or beneficiary of the account identified.
Account No.413495 Remit Payment and Forms to:
Date Establisfied 03-23-2011 REGISTER OF WILLS
Account Balance $ �3,p79,g5 1 COURTHOUSE S�UARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $6,609.98
Tax Rate X 0.120
Potential Taz Due $79320 NOTE`: It tax payments are made within three months of the
With 5°/, Discount ax x 0.95 decedenYs date oi death,deduct a 5 percent discount on the tax
(T ) $(see NOTE') due. Any inheritance tax due will become delinquent nine monihs
after the date of death.
PART St2p 1 : Please check the appropriate boxes below.
1
A �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 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 comple[e Part � �p�, 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 werA paid.
listed. � Complete Part 2 and part 3 as appropriate on the back ol this lonn.
i
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
�A-�inheritance tax form Return filed by the estate representative.
REV-7 500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished. �!
1)
aaRr 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 81/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 of Taz Calculation $
PART Tax Calculation
3 If you are making a cortection to the establishment date(Line t)account balance(Line 2),or percent taxable(Line 3),
— please obtain a written correction from the financia�institution and attach it to this form.
1. Enter the date the account was established or litled 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 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 eslablished more than one year prior to ihe date of death, ihe percentage taxable is 100°/,divided
by the total number of owners including Ihe decedent. (For example:2 owners=50°/,,3 owners=33.33%,4 owners
= 25%,etc.)
b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneTiciaries.
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 relationship to the decedent.
If indicating a different tax rate,please state OfflCifll Use Only �AAF �
your relationship to the deceden[: � PA Department of Revenue
t. Date Established 1 �
2. Account Balance 2 $ PA� I
3. PercentTaxable 3 X i�
2
4. Amount Subject to Tax 4 $ 3
5. Debts and Deductions 5 - 4
6. Amount Taxable 6 S 5
7. Tau Rate 7 X 6
8. Tax Due 8 $ 7
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 froni of this 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 penalry of pery'ury, I declare[hat the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
� Work �i�- 737- g7lv 1
Home � 30 /3
Taxpay r S+gnature Telephone Number Date
(F YO 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