HomeMy WebLinkAbout08-19-13 (3) _.
6UREAU oF INDIVIOWL Tnxes Penns Ivania lnheritance Tax � pennsylvania
PO BOX 280601 Y �.��
� HARRISeURG PA 1�128-0601 Information Notice DEPARTMENTOFREVENUE
REV-1yf3 E[UocE%EC (�L�13)
And Taxpayer Response FILE NO.21-�3�Sc�S
ACN 13143332
DATE 08-13-2013
ca �:;
ct� �;; � �
� pjjpe of Accgunt r:t �
�
Estate of LAWRENCE MALLISO� ��� c7 c� �°ngs
SSN r w?a r� �., CWecking
Date of Death 07-26-2013 ?,' �,7 �,,, ca x �f{u"�t
STACY J ZoRN County CUMBERLAND �, • .. CBitificate
101 WILLOW MILL PARK RD �'� ;-. ';� �"'
MECHANICSBURG PA 17050-1761 � G '�� � �� .,'.s
` -'n N - h
� � ..� �'Y1
Q� `u� o
T
MEMBERS isr Fcu provided the department with the information below indicating that at the death of the
above-named decedent you were a'oint owner or beneficiary of the account identified.
RemR Payment and Forms to:
Account No. 134821
Date Established 07-31-1996 REGISTER OF WILLS
Account Balance $�,�qg,�5 1 COURTHOUSE S(�UARE
Percent Taxable X 100
CARLISLE PA 17073
Amount Subject to Tax $1,148.15
Tax Rate X 0.045
Potential Tax Due $51.67 NOTE': If tax payments are made within three months of the
decedenYs date of dea[h, deduct a 5 percent discount on the tau
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.
i
A �No tax is due. 1 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 Taz 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.
C �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 complete Part � �p�, I am a sibling of[he deceased.
3 on reverse.)
� 15%a 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 of this form.
E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tau 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. \��
���
_ _ _
PART Debts and Deductions
s
Aliowable 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 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 of Tax Calculation $
PART T8X CIICUI3tIOC1
3 If you are makiny a corrscUon to the esta��ahment date(Lirre 1)�couM bWncs(Lins 2),or percent tax�le(Lirre 3),
please e�bialn a wMtten corrocfbn from the Rnanclal lnstkutlonat�a�lfcM it to!hh form.
1. Enter the date the aecount was estabtished 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[axable to you.
a. First,determine the percenfage owned by the decedent.
i. Accou�ts that are held in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts,e6t�dliehed more than one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners=50�e,3 owrl8us=33.9996,4 awners
=25%,etc.)
b. Next,divide the decedeM`s percent�e owned by the number of surviving owners or beneficiaries.
4. The amount subject to tau is deterrru�ned 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 hom the amount subject to tax.
7. Enter the eppropriste tax rate from Step 1 based on your relationship ro the decedent.
If indi6ating,a difl§rbnt t�1'ate,ple�ss atate
your re�ationship to the decedent:
1. Date Established i
2. Account Balance 2 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rate 7 X
8. Tax Due 8 $
9. With 5%Discount(Tax x .95) 9 x
�@�,�: Si�n and date below. Retum TNO.compieted and signed copies to the Register of Wills listed on the frpnt of fhis form,
along wdh a chedc for any payment you are making. Checks must be made peyaWe to"R�ister of 1�tills,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
Horrre `�
Taxpayer Si na Telephone Number Date
IF YOU NE�D FURTHER ASSISTANCE, CONTACT PENF+�YLVANIA DEF'AR7NIENT qF R��NUE
DISTRICT OFFICE, QR THE INt=IERITANGE TAX DIVISItDI'J AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020