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Home My WebLink About08-08-13 COMMONWEALTH OF PENNSVLVANIA REV-7762 EXIi 1-96) DEPARTMENT OF REVENUE BUREAU OF INDI V IDUAL TAXES DEPL 280601 � HARRISBURG,PA 1]128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 018000 BOENZLI GABRIEL H 35221 RIVERSIDE DRIVE ALBANY, OR 97321 ACN ASSESSMENT AMOUNT CONTROL NUMBER ____'_ roie "_'__'_' "'_'___ 13127277 � 583.47 ESTATE INFORMATION: sSN: I FILE NUMBER: 2113-0866 � DECEDENT NAME: BOENZLI BETTY M I DATEOFPAYMENT: 08/08/2013 I POSTMARK DATE: 08/05/2073 I CouNrY; CUMBERLAND � DATE OF DEATH: 11 /27/2012 I � TOTAL AMOUNT PAID: 583.41 REMARKS: CHECK# 9894 INITIALS: BAJ sen� RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS � REGISTER OF WILLS BIIREAU OF INDIVIDWL .�ES j[�J pennsylvania Pennsylvania lnheritance Tax PO BOX 280601 ��`i HARRISBIIRG PA 1712 8-06 01 Information Notice � DEPARTMENTOFREVENUE And Taxpayer Response •`�„"""""`�••."� FILE NO.21 �� J� /fQ/ / REVISED NOTICE ACN 13127271 I VU(�[!� k i f k R 1 DATE 07-24-2013 RECORDED OFFIC� OF RE�IS7ER OF .: .._S TypeofAccount „� Estate of BETTY M BOENZLI Savings [Cl3 F�u 8 Ffl 1 `?� Checking Date oi Death 11-27-2012 Trust GABRIEL H BOENZLI CLERK 0�� CountyCUMBERLAND Certi(icate 35221 RIVERSIDE DR SW ALBANY OR 97321-9408 ORPHANS� C�U�Z CUMBERLA�JD GO., PA FULTON BANK NA 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.3622 Remit Payment and Forms to: Date Established 03-25-2002 REGISTER OF WILLS AccountBalance $>>,7p�,pp 1COURTHOUSESQUARE Percent Taxable X 16.667 CARLISLE PA 17073 Amount Subject to Tax $1,853.54 Tax Rate X 0.045 NOTE': If tax payments are made within three months'of the Potential Tax Due $83.41 decedenCs 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 $teP 1 : Please check the appropriate boxes below. 1 A �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 other boxes and disregard the amount shown above as Potential Tax Due. . g �The information is The above in(ormation is:orrect, no deductions are being taken,and payment will be sent j"�orrect. with my response. / Proceed to Step 2 on reverse. Do not check any other boxes. C �The tax rate is incorrect. VCj 4.5% I am a lineal beneticiary(parent,child,grandchild,etc.) of the deceased. (Selecl 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 �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back ol this/orm. E �Asset will be reported on The above-identif ed asset has been or will be reported and tax paid with the PA Inheritance Tax inheri[ance ta�c 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. �I(( u PART 2 Debts and Deductions 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 requesled 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 ou are makin a correction to the establishment date Line 1 account balance Line 2 or Y 9 ( ) ( ), percent taxable(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 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 established more than one year prior to the date of death,the percentage tauable 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. Next,divide the 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 tota�ot 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 Official Use Only �aqF your reiationship to tne decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 x � 2 4. Amount Subject to Tax 4 $ 3 �, 5. Debts and Deductions 5 - q 6. Amount Taxable 6 $ 5 . 7. Tax Rate 7 X 6 8. Tax Due 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 Register of Wills listed on lhe front of this form, along with a check for any payment you are making. Checks must be made payable to"Regisler of Wills,Agent" Do nol send payment directly to the Department ot 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. Work "�— ' HomeS¢/-9�J` — '�2�' � 0��8�yy-z Taxpayer Signature Telephone Number � 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 �<r �^ 4 l . - - - --- _ , -, � .- _ .— ��, .�� y �I I .. � ri . � i-... ..'� J . .. , '1 ,� _ ` . ��" .� � � . ' . . p t!,• �'- pa., _ J f-- _ r' � U J ,--� cc - _ � o , '� ,� � � ,— �� oc� _ u. '� i+- '+- �,- ° � c� — ca i , � E6. 00 �LNZ . . _ . � rr� "� � OO W �" J. - �j� !� . f W J � � . , � �,,� ' �— c� x �= ' _ ,� Cd :�-. :n c� �[W _ (p'�q' � � ' , � - � W �V � �� f� . .. . = � � � � � � (.4 Q �/� � CP � V� � � . - - �. . � � r . , � � m �'� O " � m � cu: ' ^ in . . � � � m � � �' " _ ;�`� � ' � - ---� . ; � � � j � m : m ; . i � � o ` . a � � I � c� � a � i ' '�� I ' �