HomeMy WebLinkAbout10-21-13 COMMONWEAl7H OF PENNSYLVANIA flEV-7 762 FX417-381
DEPARTMENT OF BEYENUE -
BUREPl1 OFlNDIVIRUAI.TAXES
OEPT.ISC641
MARRiSBURG,PA i)128-Ob01
PENNSYLVANIA
RECEIVED FROM: lNHERtTRMCE AND ESTATE TAX
4FFIC(AL RECEIPT
NO. CD 01 $291
WORLEY ELIZABETH
31 CHURCH RD
CARLISLE, PA 17015-9332
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
•-----° fa�d ---------
13142651 � 5716.57
ESTATE iNFORMA7tON: sSN: 2oa•3a-622� �
PIIE NUMBER: 2113-0781 �
oECEDEr�T NAME: WALKER LARRY P �
DATEOFPAYMENT: 10j21J2013 (
POSTMARK DATE: 49(16/2413 (
CouNTY: CUMBERLAND (
DATE OF DEATH: 06/23f 2013 �
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TdTAL AMOUNT PAId: 5716.57
REMARKS:
CHECK# 190
INI7IALS: DB1
sen� RECEIVED BY: GLENDA FARNER STRASBAUGN
REGISTER QF WILIS
REGISTER OF W�LLS
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eux�u oF ianrvzwui ra�cES Pennsyivania inheritance Tax � F""n��J�V����
PO BOX 28U601
WIRRIS&UR6 PA 17128-OaOi information Notice DEPARTMENTQFREYENUE
Rnd T�payer Response ME*.xsu ex o.�trtc<w•iz�
FILE NO.2173•078t
ACtd 13142$51
DATE 48-08-2013
Type ot Aqcbunt
_ fstete of t�ARRY P WAL#QER Savings
SSN 2�4345227 Checking
Date of Death 06-23-2013 Trust
ELIZABETH D WORLEY CountyCUMBERLAND CeRificate
31 CHURCH RD
CARLTStE PA 17015-9332
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Q�rtstowN lANK provided the department with the information below indicating tfiat at the d`�'ath of the
above-named decedent ou were a bint awner or bene�ci of the ac�ount iderrtified.
AccauM No.tOQ005227 �mN Payment a�M Forma to:
Date EaR�iislisd 04.29-ZOOg REGISTER 8F WILLS
A�ouM Balance $10,056.99 1 COURTtiOUSE 9UUARE
Percent 7a�bfe X 5p GARIiSI.E PA 179'13
t Amount Sut�ject to Tax $5,Q28.SD
Tau Rete X 0.150 NE3TE': N tu�c Rgyrtre!nts are me�de withi�thrae montfis ot the
PoteMial Tax Due $754.2d decedenYs c�°ot deaatA,cf�dUCi a 5 p�cerrt t�SCOUM orr.the ta3c
With 5%Diecount(T�x 0.95} $($�Wp'fE�) #(a, �^7' �lue. Any hdweritar�ta�c due wili become�iinq�ent nine months
aiker the date otdea[h.
PART s�j 1: 1�ae check the appropriate baxes below.
t
A C]Na tax Is due. I am the�pause of#he dec:eased or t etri the parent of e deaedent who was
21 yesrs ald or younger at date of dasth.
Proceed to SYep 2 on revarse. Da naf check any other troxes and disrmgarr!the smaunt
shown sbove as Potentiat Ta�c Due.
g"��fs6 ii�csmnBtitS�is 'i"fi8 a�4e triTOtmation is correct,na deduofsorts are trei�taken.and payment w�I ba seM
orrect. with my respanse.
Proceed to Step 2 on reverse. Da not check any atirer boxes,
� ❑The tax rate is incorcect. � 4.5°l, I am a lineal beneticiary(pareni,chifd,grandchiid,etc.)of the deceased.
(Select correct tax rate at
right,and camplete Part � 12°f, �gm a sibling of ihe deceased.
3 on reverse.)
�1 15°!o Al!other relationships(inctuding rmne}.
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p ❑Changes or daduciions The intorrrtation abave is incorrect andJor debts and deductions were paid. '
listed. CompJete Part2 end part 3 as appropriate ort the bedc of this Jdrm.
E �Asset wiH be reported an The above-idenNfied asset has been or will be reported and ta�c paid wiM the PA inherita�ce T�
inheritance tau form ReNm filed by the estate represeMative.
REV-1504. Proceed to Step 2 on reverse. Do not check any ottier baxes.
P(ease sign and date the back af the form when finished.
PART D$13t$ a(iCI D@CIUGt1t3C}5
a
Ailowabfe debts and deducttbns rnust meet both of the foiiawing criteria:
A. The decedent was iegaity responsibie for paymant,and the estate is+nsufficient to pay the deductiNe ftems.
6. You�Td tfie debts after the death of the dscedsnt and can fumieh proof of payment if requested by ifie department.
(IE additlonehapa6e�reguired;you may attach 8 112"x 11"sheets of paper.)
DatB Paid Payee Descriptian Amoutlt P�;id.
Tot,al Erder on Line 5 of Tax Calcufation $
PAR7 Tau Caiculation
� 3 n������ lro�it tlM �arW etqioh K ib�ii tornr.�'or percent#axabts(ltne 3):
� pi�a�h�a ►4n ,
� 1. Enter the da0e the account w�established ar titied as k existed at the date of dasth.
� 2. Enter i!�total balance of the account Including any interest�crued at the date of death.
' 3. Enter tl�pert�rntepe af the accoi�trt that is t�sbb to you.
a. F+ret;d�irdn�#�e Qwn�rpAY�e,d,9c�tient•
i. A�ou�lhat aCbl�d"ia�triisTfar"eno�Ner or ofhtirs were 104%owned pY the Ceceiient.
i ii. For jant accoy� ��;��ear prior to the daYe of de8�th,the percentape taxable i�100%d'n+ided
by the totai nu+z�CBt ownMB k�rduQing the ddeedaM. {For enampie:2 owners=50�0,3'tSWN�3�33Mw,+4 aNmers
=25%,etc.)
� b. Next,div4de the d�1�t1v�s4Md b�ihe number of survivirry,�OtiwrerS w beneflc�ies.
4. The 8rrwurrt St�jeet to tax is�'i1i#�5 by tn�tg the arxpurrt balanpe by NYe pe�ant taxable.
> 5. Enter the totai of any debts arn!deductions clairr�ed frc�n Part 2:
_. .. , ,,
6. 7'he amount taxeble is by subb'aeNrag the debts and deductions from the ak��nt subject to tax. ,
7: . �R�w �wN�M ;i,!#lised`tiR j�rreltti0n81ti�rMther
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; t. Oats�atabiietred . 1 •
2. Account Belance 2 $
3. Percernt Taxabie 3 X
4. Amaunt Subject to Tax 4 $
; 5. Debts and Deductions 5 -
6. Amount:Taxable 6 $
i 7. Tax Rate 7 X
�`;� 8. Tax C�rae� @ -� � � �
' ; 9. With 5%Discouni f Tax x.95), 9 X
` St+e��„* ,ap[y a�i d�t►R�QM�. �?4W�+�il . !�eEq[!ed cApies to the�iepister of WiNF 1i�d u{��lr�rtE P#Uiis form,
� along+alth s c?�cfs`tar eny pmymer�t y0u are makfng.����s musi be made paYablB to"Reglstar o#V1�s,AyFoelt,` Do ricR send
payment Cirec�ty to the Daperqtter�t of Revenue.
� Under penelty of perjury, I declare that the facts i have reported above are true,correct and complete to tfie tiest oi my knowiedge and
� belief.
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Ta�c r igna Telephone Number Date
4F `!OU NE�D Ft'1�t ` f�` ' 'P°�iNCE� �i'I'AG7' !� � 1!l:�At�l1l� C3EI�A�tY�t' ��JETVUE
�^� DISTRICT OFFICE, �R TktE IN�fR#TAN�E TAX Di1�iS101+t AT 7t7-787-8327. SffFi?�1l�ES FOR
TAXPAYERS WITH SPECIAL HEARI►UG ANC110R SPEAKiNG NEEDS ONLY: 1-800-447-3Q20
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COMMONWEALTH QF PENN$YIVANlA REV-1162 EX(11-962
DEPARTMENT OF REVfNUE
OUREAU OF INDIVIDUAL TA%ES
�EPT.280601
W.ARNISBURG,PA t]t 2&-060�
PENNSYLVANIA
RECEIVED FRdM: WNERtTANCE AND ESTATE TAX
OFRCIAL RECEIPT
NO. CD 01829C}
WQRLEY ELIZABETM
31 CNURCH RD
CARLISLE, PA 170t 5-9332
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBfR
_W---- �ob -------- •-----
13137209 i 5634.93
ESTATE INFORMATION: sSN: zoa-3a-s2v f i^
FILE NUMBER: 2113-Q7$1 '
DECeDENT NAME: WALKER LARRY P �
dATEOFPAYMENT: 1OJ21/2Q13 �
POSTMARK DATE; O�/1BI�013 �
COUNTV: CUMBERIAND �
DATEQFDEATH: O6J23J2013 �
(
TOTAL AMOUNT PAID: �630.13
REMARKS:
CHECK# 189
INfTiALS: DB1
sea� RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WlL�S
HEGiSTER OF WILLS
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BUREAU OF Z����o�� r,�ES penns ►vania �nheritance Tax � Pennsylvania
PO BOX 288b01 � 4iT DEPARTMENT OF REVENUE
HARRISBURG PA 17128-06 01 Information Notice
And Taxpayer Response aFV��sfe[x n�[xec usav
Ff LE Nd.21- �3-7�'�
ACN 13137209
DATE 07-042013
Type qf Account
Estate ot E,AFt1�Y P WALKER Savings
SSN 2Q4-34-5227 Checking
Date ot Death 06-23-2013 Trust
ELIZABETN WORLEY CountyCUMBERLAND c �_;; � Certifiicate
31 CNllRCH RD
CARLISLE PA 17015-9332 '= � `�'' '�' �+
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M��,IERS isr Fcu provided the department with the information below indicating ihat at the death of the
above-nameci decedent ou were a'aini awner ar beneficia af the account identified.
Aacount Nq.26354t Re�Mt Payment and Forms to:
DaDb Ee�AShed 442i-200S REGISTER OF WtLLS
Account Baiance $8,843.79 i COURTNOUSE S4UARE
Percent Taxable x Sp CARUSLE PA 17p13
AmouM Subject to Ta7c $4,421.90
Tax Rate 7t 0.150 p��E":-!f tatsp4yrnerrts are made wifhin three montMs of tl�e
Potential Ta�c Due $663.29 �$deM's date ot death,deduc[a 5 pe�ent cGecount on the taic
Wfth 5%Discount(Taic x 0.95) $fsee NOTE•} 3cs. �3 due. Arry inheritance tax d�e wili becoine deYnquent nine months
after the date af death.
PART c�,t@�? 1: Pla�se cfieck the appropriate boxes beiow.
7
A �]Na tex is due. I am the spouse of the deceased or!am the parent af a decedent who was
2i years n!d ar yaunger at date of death.
Proceed to Step 2 on reverse. LJa nat check any ather baxes and disregarci the amount
shown above as PotentiaJ Ta�r Due.
g �The in(ormation is The above fnfarmation is correct,no deductions are being taken,and payment wiit be sent
correct. with my response.
Proceed tn Step 2 on reverse. Do not check any other boxes.
c ❑The tax rate is incarrect. � 4.5°!o i am a lineai beneficiary{parent,child,grandchiki,etc.)of the deceased.
(Seleot corcect tax rate at
right,and compiete Part � �p/o i am a sibting of the deceased.
3 on reverse.)
� 15qo AII other relatinnships(including nane).
p �Chanpes ar.deductions The information abov_e is incartec[andlor debts and c�eductians were paid. . 3
tisted: Camplete PaR 2 arnY part 3 as apprq�riate on the baek oi this Inrr».
E �Asset will be reported on The above-ide�tified asset has been or will be reported and tax paid with the PA inheri#anca Ta�c
inheritance tax form Retum filed by the esta[e representa2ive.
REV-15d0. Proceed ta Siep 2 on nsverse. Do not check any othe�boxes.
Piease sign and date the back of the form when finished.
P'0.�r Debts and Deductions
2
Ailowable debts and deductions must meei both of the foilowing criteria:
A. The decedent was Iegaily responsiWe for payment,and[he estate is insuff(cient fo pay the deductible items.
B. Yau paid the debYs after the death of the decedeM and can fumish proof of psyment it requested by the department.
pf additiona4 s¢ace is required,you may attaeh 8 5f2"x 11"shsets af paper.)
Date Paid Payee [?escrfptio� Amount Paid
Totai Enter on tina 5 of Tax Galculat+on $
PART �aX �'i11CU{r'�ti0►l
+ � �Y�+ �$+�'►�4#�iP tF�e�nt�►(�.6ne t)acpalnt (t,ine 2},ar pero�nt tauabis(Line 3),
t? pMMS�R'�+c�+�filralNs if�qli�loh[��and�tqocit�tlNs tcntn.
i 1. Enter khe date the account was established or t(tled as it existed at the date of death.
� 2. Enter the tota(b8�ance of the account inciuding any interest accrued at the date of death.
� 3. Enter the pert�ar�of.d�e�count khat is ta�tal�to you.
a. First,detemrine tl�e percentape ownad.by the decedeni.
i. Ac�ounts that are heid in trust tor"anotfier or otfiers were 400°k owned by the decedent.
_; ii. Far'oint asxou�rta mor$tha�ens year prior to the date pt death,the percentage ta�cabie is 100%divided
by�toYal number cf owners inciuding the decedent. (For example:2 owners=50°!,.3 owrurs=33.3�',6,4 owners
'� =25°k�ef0.}
; b. Next,divide the decadarA�s�p�teerataQe owne�d by the number of survivirrg owners w beneficiaties.
x'j 4. The amourn subject to ta�c is d�r�rdned by muNipiyinq the account balance by tMe pe�cent te�cabie.
;, 5, Enter the totai of any debie and d�acticros claimed ham Part 2.
;
6. The smount taxat�e is determfned by subtrec6np the debts and deduetfonsfrom'�amount subject to tax.
; 7. EMer the �ta�i r�d��1�bawed 5�,yeui ielationship tb the :. ,
� +. if indic � �� , � .
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_; Your reiaHanship to the er�t:
�� � t:� Date�Estabiished t �
;;; 2. Account Balance 2 $
�n�g
���� 3. Percer�T�able 3 x
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».- 4. Amount Su ect to Tax 4 �
� ;l bl
�4.� 5. Dabts and Deductions 5 -
`' 8. Amoun2 Ta�aable 6 �
� '; 7. Tax Rate 7 X
8. Ta�c Due 8 $
�` 9. With 5%Discount(Ta�x.86} 9 x
F' +�A� �: Sign arx!d�te lt�lpw. Rstum 7'MYQ com�I�ed end siBn�d cppies to the Register ot�.list�d on the front of thia form,
�� along with a check for arty�yment you are makirtg. Checks must be made Qayeble to"Register at WNIe,Apqnt." Do r�se�!
, � payment dirsctly to the DepartmeM oi Revenue.
Under panalty of perjury, I deciare that the facts i have repaRed above are true,correct and comptei�to the bes#of my knowledge and
� balief.
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" � T er Signature Telephane Plumber Qate
y ; i IF YOU N�ED FURTHEFi AS�ISTANCE, (;flP1TACT PEi+�Y1�1��1U1A DEPAR�'lut�NT flF REifEY+lUE
'+ �w DISTFtiCT dFFfCE, OR TNE tN##EFi1TAlYCE TAX Ot�liStU�i AT 717-757-8327. SEFt�tCES FOF
� TAXPAYERS WITN SPECIAL MEARING ANDfOR BPEAKING NEEDS QNLY: 1-80Q-447-3420
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