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Home My WebLink About10-07-13 ,,�:T. . ,..,, �..:._„-. �____ - � _ _ _ _ _ _ ______ 8�� oF INDIVIDUAL TAXES , enns lvania Po doX Z8o6o� Pennsylvania lnheritance Tax p y HARRISBI�t6 PA i�i2s-o6oi Information Notice DEPARTMENT OF REVENUE REV-1543A EX DoeEXEt(�l-12) And Taxpayer Response FILE NO.2113-0550 ACN 13503910 DATE 09-18-2013 .TYp�of A�unt: � �. . , ' Estate o#NAN�Y M`BARRY Security . , �S�+G Acc# Date ofi Death 05-03-2013 � -;St�dc , , NANCY.:S,�W.I LKENI NG County CUMBERLAND � ' ' �'�ds 12T4 ESTAT� .DR . � �, �.� LdS ALTOS CA,94024-6100 - � � � � � � � � t"�'t � � --1 C,,� �1 �„�„ y,, r-�- . . -�-� c� .� mr �'i �`�� ' t„ ::� ``� :� �► � ` � �+ A� � � � --�-� .,y�� ...� � � _�.� � �, ..�.� .: _ . . , , , < � . ; ,; � . _ . ,.�.,�.. , , ., .,.; .. , - - � ._ . .,� _ ._ _ _ ._ _ _._ _.._ ._ , __ ,:.._ . _ .. . _ _ -- . � � i� , .. -� ..� , _ _ _ _ i� . _ . . - ,_.... _.. , .. , ,. . � . r. .. , - ,.. _. - � . -. --�� - �� _ . ,, � . ,. �► , � +G"9 1� ` ...� :,.. . �: . . . �� . „�,� y�►N6UARa provided the department with the information below.indicating#hat at t�e death of the above-named decedent ou were a'oint owner or bene�cia of the account identified. Remit Payment and Forms to: Account No.1038806►1311Q64 _ Dste Egtablished REG�.STER OF WILLS ° Account Balance ': J: . $43,908.85 1��t1`OUSE St�UARE Percent Taxable X 25 ' CA�t�1.� .PA 1?Q13 ° Amount Subject to Tax $10,977.21 Tax Rate� ; , , X 0.0�5 '` � NO''�`�"':=1f tax`p��nents ar+�r�a►de��rti�th�e4e�morlths of the Pot,ential T�c D�ae„r. . ,_ �493.97 decedent's date of death,deduct a:�percen�,�,is�qunt c�n the tax With 5%Discou�t(Ta�,x,{�.95} $(S�e�NOTE*j^ due. Any inheritance tax due wil)beCOme d'elinquent nine months � after the date of death: PAR'�' c��,}?y'I:�se check the appropri�te boxes below. . . ,� � ��t is d 1 ar�the spouse of the deceased or I am the parent of a decedent,who was a [� ue. � � 21 years��41d�or yo�nger�at��da�te�of��:death. � � `� �� a � Prov�ecl�lb St�'�vn ri�verse. Do not eheck any other boxes and disr+egard�he ar»ount : : _, ; : shrow�above es`�Potential Tax Due. ,._�- �_ _-----_ - _ � ;..,...,�,�...�,� _ __ _.,. _ . __ � -�-°-- ..,,;�.:7,.�...�.� �... ,.... _ : _,:._.---;-� . _ : Th�tnfior�Ttation is� The above information is correct,no deductions are being taken,and payment will be sent ....B^�correc� ', � with my response. _ . Proceed to Step 2 on reverse. Do not check any other boxes. C �Th�,tax rate is incorrecL' � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the'deceasect. ` (Sslect`correc#taz ra�e at right,and complete Part � �p/o I am a sibling of the deceased. 3 on reve�e.) � 15% All other relationships(including none). � p �Changes or deductions The information above is incorrrect andfor:.debts and deductions were paid. . .hsted:_ Complete Part 2�r�d part 3 as appropriate on#hg back of:this form. . ., . '.: ., ,P° ; .. � �. . : r reset�tative. r �.;:. . . ,. . ; �°' ,�s�t�wili be r+e rted on, The above-��lentifie4�asset has be�n or w�ll be re rted and tax paid with the PA Inheritar�ce Tax inhe"ritance tax fotm Retum#iled by the estate ep REY-1500. Proceed'to Step 2 on reverse. Do not eheck any orh�r boxes. - . Please sign and date the back of the form w�en 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 instit��tion and atta�h it to thiS forre'. i. 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 ��.�:��1�� ,:� ,\�, � your relationship to the decedent: �,��,��,�,�\ \ 1. Date Established 1 ' � �� ; � � .�; �,; �� \\� �o� �\��\\�\\�p ��\ ��\\�� 2. ACCO U flt BaI a f1Ce 2 � `� ��A�A ,A"�`��\��\V�\��`�\�� ;' �; �� X "� `� �� 3. Percent Taxable 3 � , � ; � � , � :� �� 4. Amount Subject to Tax 4 $ � 5. Debts and Deductions 5 - �, 6. Amount Taxable 6 $ � „ � , , , , � ; �' � �� 7. Tax Rate 7 X � ��. ��, ��,�`�° '�� .; ��,�� \� �� ,,�' �-�� 8. Tax Due 8 $ �` : , :� �A\\��AVA��`�� °��\��A��V�\�� \� � �\\�\ �\\\ ��p �� \��\\\�\ ��\��\\\�� \�� \� \ �\ \�� 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 Taxpayer 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