HomeMy WebLinkAbout08-19-13 8oa�,u oF �r,o:vTO�,� r�es Penns ivania inheritance Tax '� pennsylvarria
ro aox zsocoi y "' DEPARTMENTOFqEVENUE
MRRRISBURG PA 1]128-0601 Information Notice p�y.�,y�y Ex naeErte nn-tzr
And T�payer Response FILE P1C}.21 —j�-$�
ACN 13143336
DATE 08-13-2013
Type ot Account
Estate of LAWRENCE MALZ{S�N -i ;,a � Savings
SSN � �-^' Ghecking
Date of Death 07-2&-2013 � a --- �� Trust
IAVAN E ZORN County GUMBERLAND � � �`� ci CeRifica[e
101 WILLOW MII.L PARK RD � �n � c"r � � ,,�
MECHANICSBURG PA 17050-1751 7a ya f` ti""" ��'� ..,
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MEMBfRS �sr �cu provided the department with the information below indica#ing that at ttre death of the
above-named decedent you were a 'oint owner or beneficiary af the account identified.
AocoUntNo.f82527
Remit Paymeot and Forms to:
Date Establlshed 03-12-1999 REGISTER OF WILLS ,
Account Balance $1,570.72 1 COURTHOUSE SQUARE '�
PercentTa�cabie X1B.867 CARLISLE PA t?413 (
Amount Subjeot to Ta�c $261.79
Tax Rate X 0.045
Potsntiai Tax Due $��.7$ NOTE': IT tax payments are made wiihirt ttrree months of the
decederd's date of death,deduc�a 5 percerrt discxiunt on tha tax
With 5°lo Discount{Tax x 0.95) ${see NOl'E'} due. Any inheritance tax due wi�I become delinquent nine months
after[he date of death.
PART �t@�3 i: Piease check the appropriate boxes below.
y
A �Na tax is due. i am the spouse af the deceased or!am the parent of a deceden#who was
21 years otd or yaunger at da#e af death.
Proceed to Step 2 on reverse. Do not check any other baxes and disregard the amount
shpwn above as Potential Tar Due.
g �The informat#on is The above information is correct,no deduetions are being taken,and payment wi3l be ser�t
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other twxes.
� �The ta3c r�te is incorrect. � 4.5°lo i am e Iineal taeneficiary{parent,chikl,grandchi�,efc.)of the deceased.
(Select correct tax rate at
right,and complete Part � 1"2e/a I am a sibling of the deceased.
3 on reverse.)
� 15°ld AII ott+er relationships{including none}.
p �Changes or deductions The information abave is incorrect and/or debts and deductions were paid.
Iisted. Compiefs Part 2 anc!paR 3 as appropriafe on fhe back ot ihis form.
E ilsset wifl be repprted on 7he above-identified asset has been or will be repoKed and ta�c paid with ffie PA Inheritance Tax
inheritance tax form F3eturn fifed by the estate represeniative.
EV-1500. Pmceed to Stap 2 on reverse. Do nof check any ather baxes.
Please sign and date the back of the farm when finished. ��
PART Debts and Deductions
x
Allowable debts anci d�ductians must meet 6ath of ihe foiioroving crEteria:
A. The decedent was iegaify responsible for payment,and the estate is insufficient to pay the deduotibie items.
B. You paid the debts after the death pf the deceden[and can furnish proof af payment if requested by the department.
(if additionai space is required,you may attach 8 1!2"x 11"sheets af paper.)
Date Paid Payee Description Amount Paid
Tatai Enter on Une 5 of Tax Calcutation $
PART T1X ,�`,ralCUiatlOtl
3 If ya�are makinp a correctia�to!hs eNeblishErtaat d�{Llne 1}accouwt�1su�(�e 2},or percent t�We{Line 3},
piaase obtain e wrttten carrectFan irom the Nnanaial tnslltutlon and�ttaeh tt ta this 1orm.
1. Enter the date the account was eatablished or titled as it existed at the date of death.
2. Enter the tatai balance of the account including any interest accrued at the date of death.
3. Enter the percgntage af the accauM#eat is taxab�To you.
a. First,determine the pe�centage ownad by the decedeM.
i. Accaunts that are held"in Vuct tor"another or othere were 100°k owned by#he decedent.
ii. For joint aceounts more than orie yaar�ior to the date of death,the percentage tauabie is t 00°to Gi+Jided
by the totai number ot owners including the decederrt. (For exampie:2 ownars=5f}%,8 o�s�33.�,,4 wmers
=25%,etc.)
b. Next,divide the decedarrt's owned by the number of surviving owners or beneficiaries.
4. The amount subject to tan is dete�by mul#�yinp ihe account batance by tfie pemsnt ta�caisle,
5. Enter the totai of any debts and deducfions ciaimed{rom Part 2.
6. The amount taxable is determined by subtr�eting the debts and deductions from the amount subject to tax.
7. Enter the appropriete ta�c rate from Step 1 based an yaur ralationship to the decedent.
If indicatinp a different tax rata,pieasa state
yaur relatlanship to tNe decedent:
1. Date Established 1
2. Accaunt Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject to T� 4 $
5. Debts and Deductions 5 -
8. Amount Taxable 6 $
7. Tax Rate 7 X
8. Tar Due 8 $
9. With 5% Discount(Tau x.95) 9 X
' .�9t8}} i2: Sipn anci dafe bekaw. Retum TYY4 cttmpiet�d and signed copies to the Reqister of WiNs{isfed.on the fron#of this(orm,
' afong with a check for any payment you are making. Checks must be made payabte to"Reqister of Wifls,Agent;' Do not sand
payment directly to the Department of Revenue.
Under penatiy of perjury, !d�iare that She facts 1 have repoRed above are true,corre.ct and complete to the best of my knowisdge and
bel iet.
,��,,,_/� �/ Work
(� _�'Yj".,U1�_`i.T1'L'hJ Home ��7 �'� l �t'��
Taxpayer Sign re Telephone Number Date
!F Y4U NEED FURTFIER ASSIBTANCE. GONTACT P£�l`IYANit1 DEPART�+t�E`I' # REi/ENUE
DISTRICT OFFIGE, OR TW� NVMERiTANCE 7AX D1U#SfON AT 717-78'I-8327. SERViGES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3Q20