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Home My WebLink About09-10-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96) DEPAqTMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPT.280601 HAFRISBUHG,PA 1]128-0801 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 018129 CAMPBELL RICHARD E 7 JOHN MAR COURT MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- mie '______" _"__'__ 13503479 � $2,885.10 ESTATE INFORMATION: SSN: I FILE NUMBER: 2113-0901 � DECEDENT NAME: CAMPBELL KATHERINE R � DATEOFPAYMENT: 09/10/2013 I POSTMARK DATE: 09/09/2013 I COUNTY: CUMBERLAND � DATE OF DEATH: 07/18/2013 I � TOTAL AMOUNT PAID: 52,885.10 REMARKS: C & R CAMPBELL CHECK# 286 INITIALS: D61 SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS _ _ .._.... . ... BIIREAU OF INOIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PD BOX 280601 HARRISBIIkG PA 17I2B-o6o1 Information Notice DEPAR7MENT Of REVENUE And Taxpayer Response "� „"""°°""` `°• ", FILE NO.21 ACN 13503479 � .r �: , . . , :.... - .- DATE 08-30-2013 � Type of Account __� . _ .'..; �:i� 1v ::,� Estate of KATHERINE R CAMPBELL Security SSN SEC Acct 4� Date of Death 07-18-2013 Stock RICHARD E CAMe��.4 "� ` CountyCUMBERLAND Bonds 7 JOHN MAR CTU(�, H.,��S �„U�,-l�i MECHANICSBU �.�`1�7�0¢��9f�,L� �r..,=� �;- MERRILL LYNCN 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.872 Remit Payment and Forms to: Date Established REGISTER OF WILLS Account Balance $202,464.37 1 COURTHOUSE SQUARE Percent Tauable X 33.333 CARLISLE PA 17013 Amount Subject to Tax $67,487.45 Tau Rate X 0.045 Potential Tax Due $3,036.94 NOTE': If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE`)��dg�'S.1 D due. Any inheritance tax due will become delinquent nine months aRer the date of death. PAR7 SteP y : 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 Tar Due. g u 1'he 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 � �2=�, 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 �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax 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. P"Rr 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 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 Tax Calculation 3 If you are malcinp a cortectfon to the esiablishment date(Line 1)accouM balance(Line 2),or peresnt ta�cable(Line 3), please obtaln a written correctfon from the ilnencial institutfon and attach it to thia}ortn. 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 peroentage 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 tau�ble is 100°k divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33"l0,4 owne�s =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 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. Enter the appropriffie tax rate from Siep t based on your relationship to the decetlent. If indicating a different tax rate,please state your relationship to the decedent: 1. Date Established 1 2. AccountBalance 2 $ 202�yG4.3� 3. Percent Taxable 3 X 3.�.�323 4. Amount Subject to Tax 4 $ �S7j YFS��s 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X a b�{ 8. Tax Due 8 $ 3,0.'�L.4� 9. With 5% Discount(Tax x .95) 9 X � $�j�, � Step 2: Sign and date bebw. Return TWO completed and signed copies to the Register of Wi41s listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of W Ils,AgenL" Do no[send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete[o the best of my knowledge and belief. Work 7/�-7,31��Z �r Home 7/7— /- /3� Taxpayer Signature Telephone Number Date � IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPART1vFENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVIGES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 /� /'`�. ,�"� n� a� � '�n fA�4i y � ^� � �� : `o' u'. � � �n i � � t H� '(��1 � V�"` W � �� t V y�,y P '"V �.L^? �' � � � � r � I� �� . . ' ifl Yh 4� ±,� ({� .y,� � �r* �� f" r v F� � � �� ` (T� :"- r F.> . �. L� ' •G ! T 1'ri C.-� , `�.` � - t `, 'J t'. +� t-d' � -:i ,,a ;� : � .,c - Vl rx � 4 '� '.-' '1-^ Iti e 'J i ' U .�"�.. ' � , 4 Uti -wl.. y -o .w> ;. r �. :- i. � sy .."�+ l ✓ l � ' �'1 � � ' � iM i p�y Y � � . �t, mi- i n� �A .