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Home My WebLink About08-06-13 BURFAU OF INDIVIOWL TAXES Penns Ivania lnheritance Tax �}� enns lvania PO BOX 28U601 y T P Y NARRISBURG PA nize-oso� Information Notice �j� DEPARTMENTOFREVENUE � And Taxpayer Response �E•�°<°E°�^�EYF<<.a-„> �y� FILE N0.21 a�_ � 3 _ � ACN 13130928 n c FiCE OF DATE06-25-2073 , REGISTEr� OF ;°;iILS 6 Type ot Account 1�)13 f�U� � ��Es�atel f KATHERINE CIGARAUSKAS Savings SSN Checking CLERK OfDateotDeathOS-10-2013 r��s� HEIENA RATCLIFF Ei0 CUMBERLAND 38 SUNFIRE AVE ORPHANS' C��°rt�' Certificate CAMP HILL PA 17011-LU2U �UtABERLAND CO.. Q� asecu 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. Accaunt No. 170285226 Remit Payment and Forms to: Date EsWblished 06-01-1999 REGISTER OF WILLS Accoun[Balance $3,470.34 1 COURTHOUSE SQUARE Percent Tazable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 1,735.7 7 Tax Rate X 0.150 Potential Tax Due g pgp.pg aU-� Zry NOTE': If tax payments are made wi[hin three months of the decedent's 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 Step 1 : Please check the appropriate boxes below. 1 /+ �No tax is due. I 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 otner boxes and disregard the amount shown above as Potential Tax Due. B �he i�formation is The above intormation is correct, no deductions are being taken,and payment will be seM correct. with my response. Proceed to Siep 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a{ineal beneficiary(parent,child, grandchild, etc.)ot the deceased. (Seiect correct tax rate at right, and complete Part � �p�, f am a sibling of the deceased. 3 on reverse.) � 15% All other reiationships(including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and paR 3 as appropriate on ihe back of fhis form. E �Asset will be repoRed 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. P�oceed fo 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 insufticient to pay the deductible items. B. You paid the debts aker 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.) Dale Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2), or percent taxable(Llne 3), � please obtain a written correction from the financial institution and attach it to this form. 1. Enler 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 lhat 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 established more than one year prior to the date ot death, the percentage taxable is 100%divitled by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners � =259'0,eic.) . . 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 Ihe account balance by ihe 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 amouni subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. I(indicating a different tax rate,please state Official Use Only �nqF yow relationship to the decedent: PA D2p8rtment of RevCnuB � 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percen[Taxab�e 3 x 1 � 4. Amount Subject to Tax 4 $ 3 I 5. Debts and Deductions 5 - 4 � 6. Amount Taxable 6 $ 5 � 7. Tau Rate 7 X 6 8. Tax Due 8 $ � 8 9. Wi[h 5% Discount(Tax x .95) 9 x St2p 2: Sign and date below. Return TWO compleied and signed copies to the Register of Wills listed on ihe front 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 penalty of pery'ury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. � Work Home � axpayer Signatu Telephone Number Date �/i � /� IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF VENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAY�RS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL SAXES penns Ivania lnheritance Tax ]� pennsylvania PO BOX 280601 Y NARkISBURG PA 17128•0601 Information Notice �,� OEPARTMENTOPREVENUE •cv.�sa�[�u.�cx[c i�e-tx� � And Taxpayer Response FILE N0.21 (� I_ � 3—$� ACN 13130926 S r� � DATE 06-25-2013��' �... •--- - RE6lSTER Or �."iLLS Type of Account ;fl13 �� P�EsCateOiVCATHERINECIGARAUSKAS Savings SSN Checking HELENA RATCLIFF CLER!C OCoun�yCUMBERLANDt3 Certificate 38 SUNFIRE AVE ORPHANS� CO�H� CAMP HILL PA 17011-1020 CUA46ERLAND CO., P� rsECU provided the department with the informat+on below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo. 170285226 Date Estabiished 06-01-1999 REGISTER OF WILLS Account Balance $552.72 1 COURTHOUSE SoUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $276.36 7ax Rate X 0.150 Potential Tax Due $41.45 ��9.�{(, NOTE': If tax payments are made within three months of the decedent's 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 afler the date of death. PART Step 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 younge� at date of death. P�oceed fo Step 2 0�reverse. Do not check any other boxes and disregard the amount shown above as Potential Tar Due. g �The intormation 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 othe�boxes. � �The tax rate is i�correct. � 4.5°/a I am a lineal beneficiary(parent, child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part � �Z�j, I am a sibling oi the deceased. 3 on reverse.j � 15% AII other relationships (including none). p �Changes or deductions The information above is incorrect andlor debts and deductions were paid. listed. Gomplete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has bee�or will be reported and tax paid with the PA Inheri[ance Tax inheritance tvc iorm Retum filed by the estate representative. REV-7500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when tinished. 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 ihe debts after the death of the decedent and can furnish proof of payment if requested by the department. (I!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 Tax Calculation $ PART Tax Calculation 3 If 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 lo 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 interesl accrued at the date of death. 3. Enter the percentage oi the accounl 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 established more than one year prior to the date of death, the percentage taxable is 100°/,divided by the total number of owners inciuding the decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners =zs%,etc.) b. NeM,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying Ihe account balance by the percent taxable. 5. Enter the total of any debts and tleductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amoun[subject to tax. .7. Enter the appropriate tax rate from Step 1 based on your relationship to Ihe decedent. If indicaling a diBerent tax rate,please state Official Use Only �AaF � your relationship to the decedent: PA Department o1 Revenue 1. Date Established 1 2. Account Balance 2 $ PAD � 3. Percent Taxabfe 3 x � � 2 4. Amount Subject to Tax 4 $ 3 � 5. Debts and Deductions 5 � 4 I 6. Amount Taxable 6 � 5 � 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 8 � 9. With 5% Discount(Tax x .95) 9 X St2P 2: Sign and date below. Return TWO completed and signed copies to the Register ot Wills listed on the front oi 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 thai the facis I have reported above are irue,correct and complete to the best of my knowledge and belief. WOrk _ Home '� ?J � - Taxpayer Signat Telephone Number Date 71�i� IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF R ENUE 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 a��o oF �NO7v�ow� Taxes Penns Ivania lnheritance Tax �l ��/ pennsylvania PO BO% 280601 y HARBISBURC PA 1 7128-0 6 01 Information Notice �� DEPARTMENTOFREYEN�� [[VJSq EX DwIXEC U�.IL And Taxpayer Response FILE NO.21 �f�1 . ACN 13130927 � I DATE 06-25-2�13 IlU V v^ - REGISTEt� OF V:ILLS Type of Account i�1�3 F��G � P� c�st�isof KATHERINE CIGARAUSKAS �Savi�gs SSN Checking HELENA RATCLIFF CLERK Of DBte of Death OS-10-2013 Trust County CUMBERLAND Certificate 38 SUNFIRE AVE pkpNANS' COURT CAMP HILL PA 17011-1020 CUI�BERLAND C0., PQ Psecu provided the department with the information below indicating that at the death ot the above-named decedent you were a 'oint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo. 170285226 Dafe Established 06-01-1999 REGISTEH OF WILLS Account Balance $515.42 1 COURTHOUSE SOUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subjecl to Tax $257.71 Tax Rate X 0.150 Potential Tax Due $38.66 ��,"1�, NOTE': It tax payments are made within three months of the decedenYs date o�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 aRer 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 Sfep 2 on reverse. Do not check any oihei boxes and disregard the amount shown above as Potential Tax Due. g �`ihe information is The above iniormation 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 i�correct. � 4.5% I am a lineal beneficiary �parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right,and complete Part � �2% I am a sibling ot the deceased. 3 on reverse.) t � 15°/, All other relationships(including none). t p ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and paR 3 as appropriafe on the back oi this�orm. E �Asset will be repoRed 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-7 500. Proceed to Step 2 on reverse. Do not check any ot6er boxes. Please sign and date the back of the form when finished. ' PART Debts and Deductions , 2 Allowable debts and deductions must meet both oi 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. (I£additional space is required,you may attach 8112"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 ot Tax Catcutation $ PART Tax Calculation 3 If you are making a conection to the establishment date(Line 1)account balance(Line 2), or percent faxable(Line 3), _ please obtain a written correction from the financial 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 tota!balance of the account including any interest acerued at the date of death. 3. Enter the percentage of the account lhat is taxable to you. a. First,determine Ihe percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedenl. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the lotal number of owners including the decedenl. (For example:2 owners= 50%,3 owners=33.33%,4 owners =25%,etc.) b. Next,divide ihe decedent's 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 debls and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. �. Enier 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 7 your relationship to tne decedent: PA Department of Revenue i 1. Date Established 1 2. Account ealance 2 $ PAD � 3. PercentTaxable 3 x 2 4. Amount Subject to Tax 4 $ 3 � 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ � 7. Tac Rate 7 X fi 7 8. Tax Due 8 $ g 9. With 5%Discoun[(Tax x .95) 9 x St@p 2: Sign and date below. Fieturn 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 Wills, Agent" Do not send payment directly to the Department of Revenue. Under penalty of perjury, 1 declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. WOrk Home � Taxpayer Signatu Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT O R ENUE 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 , . � ,. . , � � � n� � C" • O � y�n � � 0 N O r-� A � �� 73 t'T1 ;}'1 {7 G O � _,i G'7 C:.i W -p C� �'� 7 f�7 � n ...{ �S L� , r'6 � �- . � :a . Z � -ti.^�t 'T1 _ C7 �. p 'TI . {"J 4 '�: : C7 O �- N ' _ rn - `� O ro T � � • � V � � • � � \ 09 p� � O �S.� � � � � � � � O � 'r o.o--_ _ --- _ A C � N a� O � j .+ ` n � ,�: ' � _ _ _ _ � - - - -, � _ . r , ' _ , , � ' _ � � 1 �� ' 1 I j I I f � 0 N C � O - W �y � C:S.>'� � u� ' '�1.".�a N �- /��U V; � ' I . _.1 -� ., , , � � _ _.- -_' . _ '__t_ _ "- .� � ,\