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Home My WebLink About08-08-13 COMMONWEALTH OF pENNSVLVANIA REV-71$2 EX{i 7-9B) DEPARTMENT�FREVENUE eUREAU OF INDIVIDUAL TA%ES �EPT.280fi01 HRRPiSBVRG,PA Ri 28ASOt PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEtPT N0. CD 017996 WEISS LAWRENCE K 2 SPRUCE DRIVE CARLISLE, PA 17015 ACN ASSESBMENT AMOUNT CO(VTROL NUMBER ------- �e� ---------- �._.__ '.101 � 528,�Q ESTATE INFORMATlON: s5n�: � � FILE NUMBER: 2113-0$65 � DECEDENT NAME; ROTH SUSAN A � DATE qF PAYMENT: 0$f 08j2013 { P45TA+iARK DATE: C?8/0$/2013 � CouNTV: CUMBERLAND � DATE OF DEATH: 05/14j2013 � 4 TOTAL AMQUNT PAID: S2�.$0 REMARKS: LAWRENCE K WEISS CHECK# 2503 INITIAl.5: 067 SEAL RECEiVEp BY: GIENDA FARNER STRASBAUGH REGISTEft OF WILtS TAXPAYER BURE6U OF INDIVIOURL TAXES Pennsylvania lnheritance Tax � pennsylvania r0 BO% 280601 DEPnRTMENT OFREVENUE HARRISBURG PA 1712B-O601 Information Notice And Taxpayer Response "�"""�"`%" ��e �� FIIE NQ.27 ACN i3130760 DATE 06-25-2013 Type of Account Estate of SUSAN A ROTH Savings SSN Ghecking Date of Death 05-142019 Trust LAWRENCE K WEISS CountyCUMBERLAND Certificate 2 SPRIICE DR CARLZS�E PA 1?015-4024 t"J �� t�ri � � {�y � � ':� +7'7 C? � c:::: n �' -r, c�...� ;:."� ,,. � �.� � �. 4::'.3 �� .'.i . . . .. :'¢ U1 :+ti Y'. .;..] _Yt �I.r� r.l (�� , •,.i} � �� _ __' pwc saNK NX provided the department with the informatian below indicating tt�t�the d�#h of tF� above-named decedent you were a'oint owner or beneficia of the account idq,ntiffed. � G�, �_� 0 Remit Payrt�rrt and forms to: AccouM Na.50U4823998 Date Establlffihed O6•`04�2004 REGISTER OF WILLS Acoount Balance $384.00 1 COURTHOUSE S�UARE CARIfSIE PA 17Qt3 Percent Taxatale X 50 Amount Subject to Tax $192.06 7a�c Rate X 0.150 NOTE': If tax payments are made within three months of the Potentiai Tax Due $28.80 decedenYs date of death,detJuct a 5 petcent discouzrt on the tax With 59'o Disoount{Tarc x Q.95) $(see N07E`} due. Any inheritance tax due wili become delinquent nine months after the date of death. PA� $t�p 1: Piease check the appropriate baxes below. y A �No taac is due. i am the spouse of the deceased ar i am the parent ot s decedent wha was 21 years oId ot yaunger at date of death. Pmceed to Step 2 on reverse. Dp not check any other boxes and disregard the amount shpwn above as Po[ential Tar Due. g �TF�e irrfortnation is The a6ove information is correct, no deductions are being taken,and paymant will be seM correct. with my response. Proceed to Step 2 on reverse. Da not check any other Mxes. G ❑The t�rate is incorreei. � 4.5% I am a lineal berteficiary(parent,child,grandchild,etc.}of the deceased. (Select correct tax rate at right, and complete Part � �2=/a I am a sibling of the deceased. 3 on reverse.) � 15°ta AII ather reiatianships{inciuding nane}. p ❑Changes or deductions The information above is incorrect and/or debts and deductipns were paid. Iisted. Camptete Part 2 and patf 3 as appropriafs on the back of this form. E �Asset will be reported on The abpve-identifled asset has been or will be reported and tax paid with the PA Inheritance 7ax inheritance t�form Return fifed by the estate rep�esentative. REV-1500. Proceed to Step 2 or+reverse. L?o nof check any afher boxes, P{ease sign and date the back of the form when finished. tv�(}y� iU' PART Debts and Deductions x Allawable debts and ded�tions must meet both of the foflowing criteria: A. The decedent was tegaliy responsible for payment,and the estate is insufficient to pay the deductibie 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 attaoh 8 t!2"x t t"sheets af paper.} Date Paid Payee Description Amoun[Paid Total Enter on Line 5 0#T�Calculafion $ PART Tax Calcul�tion � Ff ya�sre m�tinpa correctian t0 it»ea�Wlaitmsnt t�s(t#ne 1}acctwnt 6�pt�(l�rre 2),or i�e►c�t taxabler{�Ins 3), ptae»e ot#eip a tirrltien correctton from tAe finendai inatiditlan and sttaah it to this torm. 1. Enter the date the account was established or titled as it existed at the date of death. 2. EMer the total balance oP the account includir�g any interesi accrued at tAe date of death. 3. Errter the peraentage of the account that is ta�cable to you. a. First,determine ths percentage owned k�y the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent ii. Far joint accaunts estatslished mae than one ysar prior to#he date of death,the perceniape Taic�qle 1s 100°7>divided by the totat number of owners inctuding the decedeM. (For example;2 owners=50%,3 otahilF�'=33.33°7,,4 owners =25%p� etC.) b. Next,divide the deCedeM's perCenfage pwned by the number af surviving owners or beneficiaries. 4. The amount subject to tax is determined by muiNplyir�the ac�ount batance by the percent ta3cable, 5. Enter Che totai of any debts and deductions claimed from Part 2 6. The amount ta�cable is determined by subtracNng the debts and deductions from the amount subject to tax. 7, Enter the apprapriate teu rate from Step t basad on your relationship to the decedept. tf indicafirrg�different ta7c rate,ptease s[ede your�elationship to the decedent: 1. Date Established 1 2. Accaunt Balance 2 $ 3. Percent Taxable 3 x 4. Amount Subject to Tax 4 $ 5. debts and Deduations 5 - 6. Amount Taxable 6 $ 7. Tau Rate 7 x 8. T�due $ $ �° �: 9. With 5°/a Discount(Tax x .95) 9 X �t�? �: Sign and date belcw. ReWrn TWO completed and s�ned cc�ies io the Repister af WitFs Iistec!an the hor�f o#this form, aiong with a chedc for any paymen#you are making. Checks must be made payabie to"Register of V�qs,Agent" Do not send payment directly to the pepartment of Revenue. ilnder�natty of perjury, 1 c�cEare that the faets(have reported above are true,correct and oompiefe to tha best of my knawiedge and betief. �� ,� q WOrk 'Lit� warne�j�7) Yy8 3G��- Taxpayer nature Telephone Number Date �y�,o��20� IF YOU NEED FURTHER ASSISTANGE, Ct�t�IT,4CT P�PIhISYLYAAIlA DEPARTMENT OF REVENUE DISTRICT dFFICE, OR THE tNtiERtTAtVCE TAX DIVlStt3N AT 717-787-8327. SERV�GES FOR TAXPAYERS WI7H SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 n,- '' � , •i� '¢� .�' � N �/p /� ./� `_ \ � 9 � �� `7 C � �..�� `� ro 5 _ ,� �� ,� � . J � f. o p 'r ^ ... G � � �� < Tr% �� `?� "1) fi �'o� � x � I �