HomeMy WebLinkAbout09-27-13 (2) i
COMMQNWEALTH OF PENNSVLVANIA REV-i 182 EXft 1-96)
DEPARTMENT OF REVENVE
BUREAU OP INpNiOVA�TAXES
OEPT.2B0801
HAflR�5@URG,PA 1]128Afi01
' PENNSYLVANIA
RECEIVEDiFROM: fNHERiTANCE AND ESTATE TAX
QFFICfAL RECEtPT
NO. CQ Q18182
MC IREARY CIAiR T
525 IG SPRING RD
NE CUMBERLAND, PA 17074-3106
�
� ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
------ ro,� °----- •------
13 i 47327 � $15.40
ESTATE i FORMATION: sSN: � �
FILE NUM ER: 2113-0953 i
o�CSDEN NAMe: MCCREARY R08ERT ERV1N F
DATEOF AYMENT: 09J27/2013 f
POSTMA K DATE: 09/26/2013 �
C4uNTY: CUMBERLAtVD �
DATE OF EATH: 08f 04f 2C?13 �
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TOTAL AMOUNT PAID: S15.40
REMARK :
C ECK# 5414
WITIALS: dB1
sEa� RECEIVEC} BY: GLENC3A FARRIER STRASBAUGH
REGlSTER QF WIE.LS
REGISTER OF WiLLS
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eo w� isase�IVmw� r,4xes Pennsylvania lnheritance 7ax � Pennsylvania
NARRI�lURG pA 1 7128-06 01 information Notice DEPApTMENTOFREVENUE
REY-1545 EX Dec[%FC 116d3)
And Taxpayer Response ���E tvo.2i-�ot 3_q�'j3
AGN t3f4732
DATE p9-70-2p13
TYPq qT;Aacaur��
Estate of ROBERT E MCCR87RR�, " r vings
SSN � � _a" _ hec�cing
Date of Death 08-042013 rn � r, � '- rust
C AtR 7 MCCREARY CountyCUMBERLAND � y„ r �.� CertifiCate
S 5 BI6 SPRING RD r � r� —�3 � -
N W WMHERLND PA 17070-3106 > cn ���; �
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P prov'tded the department with the informafion below indicating that at the death of the
abov named decedent ou were a'aiM owner ar beneficia of the acctrunt idenfified.
z� �y��� RemR Payment and Forn�s to:
Dets ahed 10-08•1490 REGI37ER OF WtLLS
Accoun Balance $g14.44 1 CQURTHOUSE S(iUARE
Percent Taueble X 16.667 CARLiSLE PA 17013
AmouM Subject to Tau $ 135.08
Tax fiat X 0.120 NOTE': if tax
Poterrti i Tax Due $�g,2� paYments are made within three months of the
decedenYs date of death,deduct a 5 percent discount an the ta�c
WYtts 5 plscount(Tax x 0.95} �(see NOTE`} due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART ,���� t; �����e sppropriate boxes below.
t
A � tax is due. i am ihe spouse of itre deceased nr i am the parent af a decedent who was
21 yearo old or younger at date of death.
I P�d to Step 2 on rr,+varse. t?a not check any other baxes anrt disregard the amount
shown ebnve as PoteMla!Tax Due.
g d7 e information fs The above i�formation is aorrect,no deductions are being iaken,and payment wiii be sent
c rrect. wiih my response.
Proceed ro Step 2 on rever&e. Do not chedc any other boxes.
� ❑je tax rate is incorrect. � 4.5% I am a lineal beneficiary{pareni,chiki,grandchiid,etc.}af the decaased.
Iect cortect tau rate at
' ht,and camplete Part dj pgo i am a sibiing of the deceased.
3 n reverse.)
� 15% All other relationships(inciudi�g rrone}.
p ❑C anges ar deduetions The informatipn above is incarrect andtor debts and deduotions wem paid.
iis ed. Camp/ete Pert 2 and part 3 as eppropriate on ths back ol this/orm.
E �As et will be reported on 7he akqve-identiTied asset has bean or wfll be reported and tax paid wrth the PA fnheritance Tax
i eritance ta�c form Retum flled by the estate representative.
R V-1504. Proceed!o Step 2 on rsvarse. Ao not check any other twxas.
Piease sign and date the back of the form when finished. �\
p"'� Deb#s and aeductions
s
Atiowak�lie�bts and deductions must maet both of the foElawing criteria:
A. 'i'he decedent was legally rssponsible for payment,and khe estate is insu8icient to pay the deductible items.
B. You paid the debts after the death of{he decede�t and can fumish proof of payment if requested by the department.
(If additional space is requited,you may attach 8 7/2"x 11"sheets of paper.)
D�te Paid Payee Description Amaunt-P�d
Totat En2er tm I.ine 5 of T�Calculedion $
PART Tax Gatculation
3 Mycusrem�k� tel�, , .. �+�ett�+st} :�t�r�.a+'�m�e(�►3?,
� p�e+�a�+a aw�o�'1� �aLi��1 M�6 tf�s ta++u
t. Enter the date the account was estaWished or titled as it ezisted at the dete of death.
2. Enter the tatal balance of the account including any intereat accrued at the dete of death.
3. Enter thepers�ntape of ihe acc�unt that is ta?cable ta you.
a. First,determitte tl�e 4x�+!ed bY tlte decadoni.
i. ACCanr�ts ttrai 8re t�d°in tEUSt tnt"artother�'Uthers were 10Q%owned by the deaedent.
ii. Far yoint acoour+ts mcxe t4�an one year prior ta ttie dete ot deakh�the perce la a %di�pd
by tha total number of ewners including the decedent (�or example;2 ow�ers=50%, ti�"��`�'9�,"�k'dWnars
=25Yo,etc.}
b. Next�divide the decedaqG's<p�a o»rrad by the number of survivinq�or.bsneficiaries.
4. 7he amouM subject to ta�c is deter+'r)ined 6y multiplytng the account belar�e by tMO�percent ta�cable.
'= 5. Erzter the iUtai W any debts and deductians ciaimed from Part 2:
6. The amount tarcaWe is�terminsd by subtrscting the�bfs and deductions hom th�attifwnt subject to taz.
7. Er�!tNe �c r81s�+rct'�1 based o�ytwr reiadonship Ib the deaes�e�t,
If��i d�eM�d�f8��P�e4Ce st�
your re ationship to the d9cedent:
i. Date Est�Nshed 1
2. Account Baiance 2 $
3. Percent Texabie 3 X
4, Amount Subject to 7ax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
� 7. Tau Rate 7 X
8. Ta�t Due 8 $
' 9. With 5°h DiscOUnt(Tax%:9b) 9 X
', J �;,Spn and da�e i�aw. Return TiAK! and s�!c�to U» ' of W��3 an ti�e fr4nk aF thls twm,
afong wittr a check for snY f!�Ymenf you are making. Ghecics must be mffide peyable to C}WM1�B,A�pnt•� Do n�eetrd
i payment direetly to the DepartmeM of Revenue.
Ursder penalty of perjury, i declare that khe#acts 1 have reported above are true,corr�t and compiete to the best ot my knowledpe and
belief.
WOrk
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i Taxpayer Sign�ture � 3e(ephone Numbar7i7-q3$-3543�g�''Z�.Ti�i`3
' IF YC7U NEED FURI"HER ABSIS"�'�E,- "�'�1' , . � . � � k I�1t�1E
DlSTFtlCT QFFlCE, t�'t T'HE 1 ' i"f'�E TAX C)t , AT 717-7!87-8827. ��ES �C3Fi
TAXPRYERS WITH SPECIAL HEARtNG AND/OR SPEAKING NEEDS ONtY: 1-880-447-3Et�i
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