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Home My WebLink About09-13-13 (3) BUREAU OF INOIVIDWL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 DEPARTMENT OF REVENUE NRRRISBURG PA 1�128-0601 Information Notice REV-15f3 E%Oe[E%EL (OB-12) And Taxpayer Response FILE NO.21 REVISED NOTICE ACN 13142021 • i • R f fi DATE OB-29-2013 Type of Account Estate of DONALD F LEONHARD Savings SSN 174-20-5117 Checking Date of Death 07-13-2013 Trust SHERRY D WALKER County CUMBERLAND A c;r Certificate 6 ACCENT CIR -�- CAMP HILL PA 17011-1021 � o ,.�.��: ,� a� _r m � y:. >>.. r_ _ �, _ ,.. , � �, �; ; „: ,_ _...-,.,..._ ,._, . : ., . , � i SUSGUEHANNA BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficia of the account identified. RemR Payment and Forms to: Account No.801823506 Date EstaWlshed 03-1&2009 REGISTER OF WILLS Account Balance $20,226.01 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 10,113.01 Tax Rate X 0.150 Potential Tax Due $1,516.95 NOTE': If tax payments are made within three months of the decedenYs 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 Step 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 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. � �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 1 p/o 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 of this form. E I y�Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax �i'inheritance tax 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 z Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment,and the esiate is insufficient to pay the deduc[ible items. B. You paid the debts after the dea[h 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 Tax Calculation 3 If you are mqkiny a correctfon to the establishment dete(Line 1)�count 6W�n�s(Line 2),or percent taxaWe(Lioe 3), pkase obtain a w�itten correctlon irom the flnandml lnstitutlon a�M stlach k to thb 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 establisfied 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%, 3 owners=33.339'0,4 rnmers =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficianes. 4. The amount subject to tax is determined by multiplying the account balance by the peraent 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 from the amount subject to tax. 7. �nter the appropriate ta�c rate from Step t based on your relationship to the dacedent. If indicat�ng a different tax rate,please atate your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. PercentTaxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tau Rate 7 X 8. Tau Due 8 $ 9. With 5% Discount(Tax x .95) 9 X St@p ,2: Sign and date bebw. Return TWO completed and signed copies to the Register of Wills listed on tne front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of 1Mils,Agent." Do not send payment directly to the Department of Revenue. Under penalty of pery'ury, I declare[hat the facts I have reported above are true,correct and complete to the best of my knowledge and belief. ,d� lN��-- wo�k 7r7 7SG 1��y Hw„e 7S7o S�S T payer Sig ature Telephone Number Date %/o /3 IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REV�NUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVtSION AT 717-787-8327. SERVIGES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020