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Home My WebLink About09-27-13 (2) COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018189 SALKELD BRETT J 29 ST ANDREWS RD SEVERNA PARK, MD 21146 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ---------- -------- 101 ( $1,541 .35 ESTATE INFORMATION: sstv: I FILE NUMBER: 2113-0436 I DECEDENT NAME: SALKELD VICTORIA W I DATE OF PAYMENT: 09/27/2013 I POSTMARK DATE: 09/25/2013 I COUNTY: CUMBERLAND � DATE OF DEATH: 01/10/2013 � � TOTAL AMOUNT PAID: $1,541 .35 REMARKS: CHECK# 5535 INITIALS: MAW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS __ , __ _ �/��C� B�R�►u oF �NO��nu�� r,�ES Penns Ivania lnheritance Tax � pennsylvan�a PO BOX 280601 y HARRISBUR6 PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REY-1543A EX DocEXEt(i6-12) And Taxpayer Response FILE NO.2113-0436 ACN 13503406 DATE 08-28-2013 Type of Account Estate of VICTORIA W SAL�CELD -- Security �; R�.� SEC Acct Date of Death 01-10-2013 � o s�'' c� Stock BRETT J SALKELD Courrty CUMBERLAND t� �' ��"T, `�_' - Bonds 29 SAINT ANDREWS RD t"►'t �` � �'-= �� SEVERNA PARK MD 21146-1433 �' �. r-� � � � ��' --.] ' .:i �► � ,.,,, .... .'""+�.,. . � ,��.: . C7 �-�, �„� �-.,-; �-`� �"� �'' .,,=.i ,�...3 ; :� �' t--_.� . . � � �� —-� � ''� �y, � t,i� ,��. �-"'� C`i"7 _'�'d T _ r.�wyn,�, ,�.. -q.,..,..,�;,,.,.,.a__ --. AMERICAN FUNDS 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,62750872 Remit Paymerrt and Forms to: Date Established REGISTER OF WILLS Account Balance $1 p2,757,g5 7 COURTHOUSE SGIUARE Percent Taxable X 33.333 CRRLISLE PA 17013 � � Amount Subject to Tax $34,252.27 Tax Rate X 0.045 NOTE": If tax payments are made within three months of the Potential Tax Due $1,541.35 decedent's 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. PA� St@p 1 : Please check the appropriate boxes below. � A �No tax is due. I am the sp�ouse of the deceased or I am the parent of a decedent who was 21 years Qld or younger at date of de�th. Proceed to Step 2 on reverse. D�o not check any other boxes and disregard the amount shown above as Potential Tax Due. _ _ .. ° � _. _ _ : _ _ _ __ _ g The mformation 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. C �The tax rate is incorrect. [� 4.5% I am a lineal benefiaary(parerrt,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part � 12% 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 andlor debts and deductions were paid. tisted. Complete Part 2 and part 3 as apprr�riate on ihe 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 Retum filed by the estate representative. REV-1500. Proceed to Step 2 on neverse. Do not check any other boxes. Please sign and date the back of the form when finished. � PART 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 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 making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), p!ease�bta�n a writ�n correction from the financial institution and attach it to�his 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 established 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=33.33%, 4 owners =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 appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state � ,��;,��,��,�� ;,��,� �� ,� your relationship to the decedent: �` �� ` � � � �� "�� ; �`�� ` , � ��.�� ;��`;��, �.� � . ��'�� \��V�� A�� A�\�A��`�\��°�V��\� A�� 1. Date Established 1 � � � � � , \ � , , , �� , � �� , �� , � �� \\ � � �� A�� \� �� \� ��\\�� ` �\ ��\��\��\�\\\��\�\ 2. Account Balance 2 $ �� ' �� ,� � �� ,��.°��"�„'�� `", �� .� � � � � � �� \\�� \�� \�� \ \ \\� \\�� \\\��\� X \�� \ \\o � �� \�\�� . 3. Percent Taxable 3 °° � �� `��° � �` �� \�� \\�� \� � \ \� \ �� A �. �� o\� �VAV`��\ �� ` � � �� A�� 4. Amount Subject to Tax 4 $ " � � � � � �� \\ �� :�\ �� \ � ��\�\\�� \�\� �\,\ ` � �\ � ��\ ��\ ;� \� ��\\ � \ . \ . 5. Debts and Deductions 5 - , " � �� ` ��,��,��` ��'�� '� �..�:�� , ��, ��, � � � ; � ;��, �� ; �, � �,� , �� 6. Amount Taxable 6 ��.. �� .� �,; ��;; � � �� ,� ��; T + �( � � � � � ; ��„ �� \; ��; 7. IaX RaLe 7 '` ,':a\ \ \\\, �\�\ \\„ �\\� ��\ \� \\\ �Q �� \ � \�\ �� `�� \�� \�\ ��\ �� \� \ � � � �\\ ��\��\�� \ � �_� \ ; �� \ 8. Tax Due 8 $ '��\\,� ��\ � �\� � \�\O�\- ��\�\�� \ \��\��\\�\\�\�\�� .�\ � �� `�A`��AV�`� \ �`°�VA�� \��\\�VA��\�A`�� \ �� A�AA � �� A� 9. With 5% Discount(Tax x .95) 9 `' ' �'� ' � ' . � � X ..,,. ...,......... . .._�� ._�..., � �..,......��_...�.,.��,...�.... ��...�..��.� ��_�_..:��..,.��:.:.� Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills 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 Wills,Agent." Do not 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 to the best of my knowledge and belief. Work �/f(� �� 1 U I .� l � Home�-1l U �� G�/'� � .�`�, axpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 __ ___ __ __ ___ _ __ _ � __ _ BUREAU OF INDIVIDW4L TAXES PCI�nS IV$nIS II�I�erl�Ce TaX � pennsylvania - PO BOX 280601 y DEPARTMENT OF REVENUE HARRISBURG PA ��28-060� Information Notice REV-1543A EX DocEXEC(�l-12) And Taxpayer Response FILE NO.2113-0436 ACN 13503406 DATE 08-28-2013 � � Type o��`cco nt� � Estate of VICTORIA W SALK�D� •`.-J'r � Url�/ t�r� � ,� � �_ : EC Acct Date of Death 01-10-2013 �?' �. r-� tock B�tETT J SALKELD Courrty CUMBERLAND ,�,,,�, � !'?°� � ? .� nds 29 SAINT ANDREWS RD � � �� -� � SEVERNA PARK MD 2i146-1433 � � �' c"� •w� �`' `� �7 C� �� ~-a .''.� �? C; ;.° `-�-�' _..ti„� , � �� ..,.. . ',. � � � �,..... f,"8 C-�1 C:t� �'a � `rp , � � . _ • , * _ _ __ , .. -. ,,,. --..4_._ . -- . .. . __... . _. .. ,. . ,.,, __ . _ _. _ ,. __ _ _ AMERICAN FUNDS provided the department with the information below indicating that at the death of the above-named decedent you were a'oint owner or benefici of the account identified. Remit Payment and Forms to: Account No.62750872 Date Established REGISTER OF WILLS Account Balance $102,757.85 � C4URTHDUSE SQUARE Percent Taxable X 33.333 CARl�.SLE PA 17013 Amount Subject to Tax $34,252.27 Tax Rate X 0.04b NOTE*: tf tax payments are made within three manths of the Potential Tax Due $1,541.35 decederrt's date of death,deduct��5 peree�#discount on the tax With 5%Discoun�(Tax x 0.95) $(see NOTE") due. Any inheritance tax due will become delinquent nine months {'� after the date of death. PA� t@p 1: Please check the appropriate boxes below. � �� A � No t�x is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years otd or younger at date of death. Procaeisa►to 5`tep 2 on reverse. Do not check any other boxes and disregard the amount , ; sh�wn�bove as PQtential Tax Due: �.. . _�_�.__....__�_.___•�. -..�.-. _ � ..� � _. .��. .�,...;�..._._. _____ v _�. _ . ,- �. g - The�'fnftsrmation is The above infonriation is correct,no deductions are being taken,and payment will be sent correct with my response. Proceed to Step Z on reverse. Do not check any other boxes. C �The#ax rate is incorrect. �4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. � (Select correct tax rate at �ight,and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15%o 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 ap,propriate on the back of this form. .t E �Asset rvilhbe reported-on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax ir�heriiance taar form Retum filed by_the estate representati�e. ��'�'' REV��5�. Proeeed 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 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 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 making a correction to the estabiishment date(Line 1)a�count balance(Line 2), or percent taxable(Line 3), . �!easp o�ta�n�wri�±pn correctBon#rom thQ f��anrial ��stitu#�e►�3nd atta�h�#te±�:s#�rr*�. 1. Enter the date the account was established or titled as it existed at th�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 established 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=33.33%,4 owners =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 appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state ,�,\��\\��\��i��;��;��\��, `�� your relationship to the decedent: ��` ��`��"�`�� ` � `��"°� � ` � ` ' ;, �� .��.��'��`�� ;�� , } + l.� 4, ,.I � \� �\� � ��\�\��\� � � � \�\ \ � � . ,- \ ��\\�\\\��\\��\\\�o�� \��\�\�\��\\��\\��\��\\�� `� 1. �aLe' �$lt�U�l$1 IeU � �� vyy� � �v �y v O � v� ��y��vv`y�v�vv�v�� \�� \� �� \�\� \�\ �\ .\ �� \\ \\�\�� \\��O� �� \\\��\�\\�\� \� � � � `��\�\�\�`\�\� 2. Account Balance 2 $ \ \ \ \\ \ ��i�\\\�\��\��\��\�� \` \�� `��\��\��\\��\��\��\ ��A�� A��V\V��V�� \V�� . 3. Percent Taxable 3 � '�� \\��\ .. �� \ o�� \� ��\�� .�� X ��\\�\��\\�\ ��\��\\\ ��\.��\ � � � \\�\ \��\� � ��: �\ �- \��\ ��. \ � � �� \� \\� \�� _ �� 4. Amount Subject to Tax 4 $ ° `�` �� ; � � � �� ' � � �� \\\ � �� \\��\� ��' � �� \� �\�\ ��\�� ;,,.��.�_,...� � . ... :-�.. .:,..,� .\,:. �\�\ �\.,.o ��„;,� �. 5. Debts and Deductions 5 - \ \ � �� \\�� \ ��\\\��\�\ �� . .,., \\\�� \ � . \ . ��\\\ � \\�� \�� V � A� VA �� 6. Amount Taxable 6 $ �� ` \ ��\� � � \ �� \ \ �� \�� \ �� \ � �\ \ \� �� \�� \\� �� \\� ��\ \ \��\\�\: � � � �� \�� 7. Tax Rate 7 X � , ��r��.��;,�� ' ' �� ;�� '� ` : �� ' ` ' ; � , � 8. Tax Due 8 � �.�� ,� � � � � � �� \\��A � �� A��A� `\V � �`�� V .�� \��A�� \�� \\\ �� \\\�� . �. \�� \��\� �� \ � � � � 9. With 5% Discount (Tax x .95) 9 X .��,��;��..��.�.,:: �.��...��....�� ....:<..��,��:��.:�.��,..��,��_:; Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills 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 Wills, Agent." Do not 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 to the best of my knowledge and belief. — �--s�� ,,._.e�.- Work ��J ' � C�� /' �'�� Home � � �.- Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVE E DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 � . �. r ,. ,. .� W t(�� . � . � . , � —"..� : � � �;y . . . ,.. .. - �. �� Q1 � �,. ��c�� _ -� ' � � o,:, �R� �- . �i � ,� �; R��:� . . �..�i� . _ y � N � `� � r r, ,-: r -� . ,^`� ,,'; '_� � ► ! .1 .� �„i�; �-� r i:.- . 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