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Home My WebLink About10-24-13 (2) BUREAU OF INDIVIDWL TAXES � pennsylvania PO BOX 280601 Pennsylvania lnheritance Tax HARRISBt�G PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REY-1543 EX DocEXEC(�6-12) And Taxpayer Response FILE NO.2113-1008 ACN 13154569 DATE 10-15-2013 Type of Account Estate of BETTY C BARNES Savings Checking Date of Death 09-05-2013 �-.w: rust WILtIAM E BARNES CountyCUMBERLAND � `_�' ertificate 1341 EMERSON DR �� M�UNT JDY PA 17552-7238 Q � ��:«� � � � Ca �°"# � � � � �7 `�.,> � � i� C'� f'�' , ,�., � �,, � �� ,,�. _.�, -� �:M �.w� �.", �a :-;; ...� .,,�,a � <.w� "j t�..� t,..,, ' ► ,��y C� �' !""` 1"�"l :�s� -^-'� r� C!"f � C3��a "�� wE��s FARSO provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficia of the account identified. Remit Payment ar�d Forms to: Account No..3000248391963 Date EstabNshed 03-22-2011 REGISTER OF WILLS Account Balance $3,658.13 1 COURTHOUSE SGIUARE Percent Taxable X 50 CARLISLE RA 17013 Amount Subject to Tau $1,829.07 Tax Rate X 0.150 NOTE*: If tauc payments are made within three morrths of the Poterrtial Tax Due $274.36 decedent's date of death,deduct a 5 percent discount on the tax With 5°!o Discount(Tax x 0.95) $(see NOTE''} due. Any inheritance tax due will become delinquen�t nine months - � after the date of death. PA'� Step 1: Please check the appropriate boxes below. � A �No tax is due. 1 am the spouse of the deceased or I am the parent of a decedent who was 2��ears old�ar yaunger at date of death. Pro�ae�d to Step 2 on r�everse. Do not chedc any other boxes and disregard the amount _ � ._ . . - � .,. A�� . �;.: .,. :. . . - �.._. �. _.�,.�.�w__.� _..��.�__ _......._�a_..._ . -.- , , �:�.�� -�.�„�.�,.,�Qte__n�.� �t 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 ta�c rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Setect correct tax rat+e at right,and complete Part � ��/o I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). ; � ' • : - ► ' �Changes or deductions �The information above is incorrect aCad/or debts and deducti+��were paid. � � li�.�,, ' Complete Part 2 and p�rt 3 as�propriate 0n the b�c�C of this�iria�. . . . f. E (�(Asset will be reported on The above-identified asset has been or wilt 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), please obtain a written correction from the financiai institution and attach ii to this Torm. 1. Enter the date the account was established or titled as it existed at the date af 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: �� ` �`� � �� ,��\��; 1. Date Established 1 , � � �� \��;;��, � �A`�� ;��A �� A��AV�` � O�� A�� 2. Account Balance 2 $ � �� ,�� , ��,� � � \: �� \�� \ �\�: �� \��\�\\\�\��\�� 3. Percent Taxable 3 X � \ , \ �� ;, �,� �� ,��. \�� . � � ��\��\\��\\�� 4. Amount Subject to Tax 4 $ �� ,� �� .,.. � � -�� \�� ,�� 5. Debts and Deductions 5 - �� , � � � � „�� °\ \ � �� , � 6. Amount Taxable 6 $ �� , �, � � � ` � ` ��. ' ?. T�Rate 7 X �: � � �� ' � �� .� ��. � ,� T � � � \ :� � �\�� . � ; \\� � ��.�\\��\� �. 8. I aX DUPi O � , �\�� \��' �� \��\��\� ��\�\\��\ � �: � �� \��\\�� \\\ � � � ��\\��\\�\�\��\�\\��\:�: , v ;\ . . � . . . 9. With 5% Discount(Tax x .95) 9 �� _ „ �� , � � .,_,_, .��......�,��..��,.,� ,_,.,�.: .,..,..___.,.�.�, �..�._:,��.__.�.��A��.,�_�,�,.�A\' 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`1 �"1 --•��5 a --��i2, j ��.J� Home � � Taxpayer Signature �-5��.� 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