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Home My WebLink About08-29-13 euR�u nF �NO,�,a�� TAX�s � pennsylvania PO BUX 28D601 Pennsylvania lnheritance 7ax MARRi36tatG PA 17SZS-n6ai infarmation Notice DEPARTMENTOFREVENUE And Taxpayar Respanse R"��""�"E"` `�`"' FILE N0. 2113-0489 ACN 13128810 QATE OB-18-2013 Type of Account Estate oE J4EL L H�VER Savings SSN Checking Date of Death 04-02-2013 Trust CNRISTSN6 L GUTSNALL CountyCUMBERI.AND Certifioate 164 &U��S HEAD RD NEWYILLE PA 17241-4613 �, C7 �_' c �- � rn � ° - �`T? <-a w �, c" _ c7 rn s � �:; �� -� z� � r.,. P .;, � �.,;.,: r� :, �..[, � U, :: i, . � � � . �, . c, <.> __3 , �RO BANK provided the department with the information below indicating th�L�e deatlth of the; � above-named decedent yau were a 'aint owner or beneficiary of the account id`e t+Tied. � i> t—i , � c.> Remit Payment and Porms to: = `3 ACOOUnt No.2840225847 Date Established 02-14-2012 REGISTER OF WILLS AccourriBalance ��,7}3.gp 1C4UFiTHQUSE54UARE CARLIS�E PA 17013 Peroent Taxable X 50 Amount Subject to Tax $556.95 Ta�c Rate X 0.156 Pote�tiai Tax Due $63.54 NOTE': if tax payments are made wiihin khree months of the With 5%Discount Tax x 0.95 decedenfs date of death,deduct a 5 parcent discount on the taz ( ) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the dafe of death. PART St�p 1 : Please check the eppropriate boxes belaw. 1 A �No tax is due. t am tfie spouse af the deceased ar {am the parent af a decedent wha was 21 years oid or younger at date of death. Proceed to Step 2 on reverse. Do not check a�y other boxes and disregard the amount showrr above as Pofentia!Tar Due. & ��1e information is The above informatian is correct, no deductions are being taken,and payment wil�be sent (ptlE,ct. with my response. Proceed to Step 2 on reverse. Da noi check eny other baxes. C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandohild, ete.}of the deceased. (Select corcect tax rate at right,and compiete Part � }2q, a am a sibiing oi the deceased. 3 on reverse.) � 15% All other relationships (including nane}. s fChan es or deductions The information above is incorreci anrllor debts and deductions were paid. � �—"'�stedg Gomplete Part 2 and part 3 as appropriate on the 6ack of this fon». E Asset wi1l�reported on The above-identi�ied assef has been ar wili be reported and tax paid with the PA lnheritance Ta7c inheritance tax form Return tiied by the estate representative. REV-1600. Proceed to Step 2 on reverse. Do not check any other boxes. Piease sign and date the back of the form when finished. PaRT Debts and Deductions z Allowabie debts and deductions must meei baih fff the following criteria: A. The decedent was legally responsibte for payment,and fhe estate is insufificient to pay the deductiBle items. B. Yqu paid the debts after the death of the decedent and can furnish proof of payment ii requested by the department. (if additiona4 space is reguired,you may attach 8 t 12"x 51"sheets of paper.) Date Paid Payee Description Amount Paid Tatai Enter on Line 5 ofi Tax Calculatian $ Pp�T Tax Calculation 3 If you are rnairJ�a oatrection tc the estabiishment date{Line t)�caint t��m�{line 3},or perceM taxaWe{line 3): pfease obtaln a wr[tten�rorrection from the financlai insiltutlon and attach It ta this tarm. 1. Enter the date the account was established ar titled as it existed at the date of death. 2. Enter the tata{balance of the acoou�t including any interest accrued at the dete of death. 3. Enier the percenfage of the account that is taxabie to yqu. 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 join#accaunts established moee than one year pripr to ihe date of deaih,the percent�e L�cab�is 744°h d'tvided 6y the total number of owners inc(uding the decedent. {For exampie:2 owners=50%,3 owners=33.33%,4 owrre�s = 25°/n, etc.) b. Next, divide the decedenYs percen[age owned by the number of surviving owners or beneficiaries. d. The amount subjeci to ta�c is�termined by mutGpiying the accauni bala�oe by the percent taxabie. 5. Enter the total of any debts and d�luctions clsimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions irom the amount subject ro tax. 7. Enter the appropriate tax rate from SSep 1 6ased on yaur reiationship to the decedenf. If indicahng a differer�tax rate,please state ; � your relationship to the decedent: 1. Date Established 7 2. Account Ba(ance 2 � 3. Percent Taxable 3 x 4. AmoUnt Subject to Tax 4 $ 5. debts and Deduciions 5 - x 6. Amount Taxable 6 $ 7. Tax Rate 7 X -L c 8. Tax Due $ $ 9, With 5% Discount (Tax x .95) 9 x +�'' ��@�? �: Sign and date below. Return TWQ comp(eted and signed copies ta the Register ai Wi1Is Iisted on the fronk of this form, along with a check f4r any payment you are making. Checks must be made payabie ta"Register of Wiiis,Agent" Do not send payment directly ro the Department of Revenue. Under pena{ry of perjury, 1 declare ihat the facts I have reported above are true,cprreci and compteie to the txst pt my knowiedge and belief. q �� WOfk ��1 �d�1 �1 -�/7 f.SS ..}a'R-,.�"`.�'-�*��-- t I 7 H4[Tt8 ��2� � l::3�3 Taxpayer Signature �4'�k '"}'r„` �x;� Telephone Number D2te IF Y4U NEED FUftTHER ASSISTANGE, CONTACT PENNSYGVANIA DEPARTMENT OF REVENUE DISTRtCT OFFICE, QR THE INHERETANGE TAX DIVtSIQN AT 7t7-7$T-$327. SERViCES FOR TAXPAYERS WITH SPECIAL HEARiNCi AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020