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Home My WebLink About09-18-13 (2) BUREAU OF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � pennsylvania PO BOX 280601 y HARRISBURG PA 17128-0601 tnformation Notice DEPARTMENT OF REVENUE REV-1543 EX DocEXEG (�l-12) And Taxpayer Response FILE NO.2113-0690 ��;� '° '�� ` °r� :: �� ACN 13145247 .- , DATE 08-26-2013 . _ � . . ,.�;s s� r. . . . . . . .��;� t. _� !.� 3 i i !� �1 TYpe o#�kcc4unt +4 -� ,_ Est�te of ELIZAB'�TH E WATTS ' Savin$s ��..��.��" `�=:� � Check�ng ��,�A��. ��3�� Date�o/f Death 08-C142013 ,T�ust ROBERT C WATTS Coun CUMBERLAND ��ificate 834 GRANTHAM RD �(��$��L��, �� ;?�� GRANTHAM PA 1�027 ,. � � . ... _ . � - - -- . .�. . CITIZENS BANK OF PENNSYLVANIA provided the department with the information below indicating that at the death of the above-named decedent ou were a 'oint owner or beneficia of the account identified. Remit Payment and Forms to: Account�ia.-.61 t�0'�06990 Date Established 06-06-1966 REGISTER O�WILLS Account Ba�ance $��9,47 1 COURTHOUSE SQUARE Percent Taxable X gp CaRLISIE PA 170'�3 � Amount Subject to Tax $79.74 Tau Rate X 0.1�0 NOTE": If tax payments�are made w��iin�three monfhs of the �� Potential Ta�c Due $11.� decedent's date of death,deducf a 5�pe�cent�tlis�ount or�the tax With 5%Dis�ount(Tax x 0.95)' $(see NOTE*) due. Any inheritance tax due will become delinquer�i nine months after the date of death. PART �te� �: P1ee�e�heck the appropria�e boxes below. � A �No#ax is due. 1 am the spouse of the deceased or I am the parent of a decedent who was 21 years old ar younger at date of death. _ Proceed to`Step 2 on Feverse. Do nor check any other boxes and disregard the amount shown atx3we 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. C �The tax rate is incorrect. � 4.5%o I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Setect 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.�faove is incorrect and/or��bts�ar�d deductions�rere paid. , listed. - �: �. � Complefe Part 2 and part 3 as appropriate on the back�f�this form. ` , ,J�sset�vill be;.reported on The abo�re-identified asset has k�en or w�ll be reported and tax paid with the�'A InF►erita�ce Tax E � inheri�nce tax form Retur�filed by the es#ate repr�sentative. - V-'�500. 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 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), please obtain a written correction from the financial institution and attach it to this 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 ;,' ��(��,��p�� _ � � your relationship to the decedent: ' ��a.t'��fl� ��3!£'t7€,�� 1. Date Established 1 '�� :�'�� : � � � .�' ...� � 2. Account Balance 2 $ �� 3. Percent Taxable 3 X � � 4. Amount Subject to Tax 4 $ � 5. Debts and Deductions 5 - � 6. Amount Taxable 6 $ �� . � � 7. Tax Rate 7 X � � 8. Tax Due 8 $ � �. 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 � � ( �--� � � � � ,---''� � � � � Home ^ �- t�� {Z �.J' `a�,t-='''1'—'' ;. w Taxpayer Si ature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. 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