HomeMy WebLinkAbout09-27-13 BURFAU OF INDIVId9pL rnxES Pennsy{vania Mnheritance Tax r pennsylvania ,
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HARftt58ffRG PA ll128•Obol information Notice DEPAft7MENTOF ftEYENUE
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And Taxpayer Response Fi�� tvQ.2t-13- IU�3"'�
ACN 13145347
DATE 08-27-2413
Type of Accrount
Estate af IUGILIE L$UDA Savings
SSN 179-16-6568 Checking
Date of peath 07-15-2013 Trust
RONAtD s BUDA County CUMBERLAND Certificate
443 HOMMEL AYE
tEMOYNE PA 17043-1955 � � -
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r� x� T BANK provided the department with tne information beiow indicating that at the death oE the
above-named decedent you were a 'oint owner or beneficiery of the account identified.
Aacaunt No.28860071 Remk Payment and Forms to:
Date Establlshed 06-26-1991 REGISTER OF WiLLS
Account Balance $1,233.35 y G����USE SQUARE
Percent Taxabie X 56 CARLi5LE PS 17p13
Amount Subject to Tax $618.6$
Tax Rate X 0.045
Pote�Gal Tax Due g 27,�5 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°!o Discount(T�x 0.95) ${see NOTE') due. A�y inheritance tax due will become delinquent nine months
after the date of death.
PART gtep 1 : Please check the apprapriate boxes below.
1
A �Na tax is due. i am the spouse of the deceased or I am the parent af a decedent who was
21 years old or younger a#date of dea#h.
Proceed ro Step 2 on reverse. Do nof check any other boxes and disregard the smaunf
shown abave as Potential Tax Due.
g �The information is The abave information is correct,no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on r�verse. Do not check any other boxes.
� o The tax rate is inoanect. � 4.5% I am a lineal beneficiary{parent,child,grandchild, etc.)of the deceased.
(5elect comect tax rate at
right, and complete Part � 12°fo 1 am a sibling of the deceased.
3 on reverse.)
� 15°la AH aiher retationships{including none).
p O Ctranges ar deduciions The+nformauon above is incorrect andlor debts and deductions were paid.
fisted. Complete PaK 2 and part 3 as appropria[e on the back of[his 1orm.
E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA inheritaace Tax
inheritance S�farm Return filed by the estate representative.
EV-1500. Proceed ko Step Z on reverse. Do not check any oiher boxes.
Please sign and date the back of the form when finished. ��r
PAR7 Debts and Deductions
2
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 ihe debts after the deaih of the ctecedent and can f�rnish proof at payment if requesteei by the department.
(If additiona!space is required,you may attach 8 112"x 11"sheets af paper.)
Date Paid Payee Description Amou�t Paid
Total{Enter on l.ine 5 of Tax Galculation $ �
PaRr Tax Calculation
3 If you are making a correctien to tha establishment date(Line 1)account baiance(line 2),or percent ts�cabie(line 3},
please obiain a written carrection from the Hnancial InstRution and attacN it to this form.
7. Enter the date the account was establishec!or Titled as it existed ai the date qf deatB.
2. Eoter the[ota!balance of the account inctuding any i�terest accrued at the dete of deatfi.
3. Enter ihe percentage qf the account that is taxable to yau.
a. First,determine the percerrtage owned by the decedent.
i. Accounts that are heid"in trust for"another or qthers were 100%owned by the decedent.
ii. For joint aacounts established more than one year prior ro the date of deaih,the percentage t�ixable is 1609`a divided
by the total number of owners including the decedent. {For example:2 owners=50°1a,3 owners=33.33°k,4 owners
=25°!0, etc.}
b. Next,divide the decederrt's percentage owned by the number of surviving owners ar beneficiaries.
4. The amount subject to tatt is determined by multiptying the accounk balance by the pement tauable.
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 amaunt subject to tae.
7. Enter the appropriate tax rata from Step 1 based on your relationship to ihe decedeM.
iF indicating a diffarenf ta�c rate,please state
your relationship to the decederrt:
1. Date Estabiished 7
2. Account Balance 2 �
3. Percent Taxab(e 3 X
4. Amount Subject to T� 4 $
5. Debts and Deductions 5 =
6. Amount Taxab�e 6 �
' 7. Tax Rate 7 x
8. Tax Due $ $
9. With 5% Discount(Tvc x.95) 9 X
Step 2: Sign and da2e below. Retum TWQ completed and signed copies to itre Register of Wiiis listed on ihe front of this forrn,
along with a check for any payment you are making. Ghecks must be made payabls to"Registar af Wills,Agent" Da nat send
payment directiy to the Department of Revenue.
Under penatty of perjury, I dec�are tfiat the facts I have reported abave are true,correct and complete to tha best of my knomrledge and
be(ief.
Work y�
X ,1�-., r5 N , S� Q'3 t1,0 � , Home �I e�r`���
Taxpayer Signature Teiephane Number Date
IF YdU NEED FURTHER ASSiSTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFiCE, OR THE INMERITANCE TAX DIVlSlQN AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEt?S t}NIY: t-840-447-3Q20