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Home My WebLink About10-28-13 COMMONWEALTH OF PENNSVLVANIA REV-1162 EX�11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUALTAXES DEPT.280801 HARRIS9URG,PA 1 J 128-0801 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018328 COYLE SALLY L 548 ALLENVIEW DIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- �ea ---------- -------- 13151938 � 5246.18 ESTATE INFORMATION: SSN: I FILE NUMBER: 21 13-1 138 � DECEDENT NAME: WINTERS JANE L I DATEOFPAYMENT: 10/28/2013 I POSTMARK DATE: 1 O/28/2013 � COUNTY: CUMBERLAND � DATE OF DEATH: 1 1/21/2012 I � TOTAL AMOUNT PAID: 5246.18 REMARKS: CHECK# 6534 INITIALS: CJ SEAL REC'EIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BURE#U OF SNbIVIWRL iAXES �pennsytvama ro pwc aeasol Pennsylvania lnheritance Taac NARRISeURG PA ll128-O6P1 „..Ijnforma�3tiopn[N�otice DEPARTMEN70F REVENUE AI IY��pRY�i� (l�i��ns�i IIfY-]SN EI OeC6%FL[�413> FIIE NO.21 -f'�j�� ACN 13151938 DATE 10-Q34013 REGISTc;� (}r `;'.'ii�i_S Type oi Account ��i3 ��i �� `�(� � �ateofJANELWINTERS Savfngs S�N �Ghecicing Date of Death 11-21-2012 Trust SAILY L COYLE �«�� Q�� CountyCUMBERLAND Certificate 548 ALLENVIEW OR ORPHAP{S' �(i(J;�'� MECflAHICSBUR� PA ST055-6�i�'��k�{j} �� a� SOYERESCN a�c provided the department witti the infarmatian below indicating that at tfie death of tt'ie above-named decedent ou were a aint owner or beneficia af the ac:count identified. a�c Na.rt��oesyTa �e t+ayma+t a�w Fams w: D�s EslabNshed 10�11•2002 REGISTER Of WiLLS Account Balanca $10,941.15 � �E�Ap� Pet+ceM Tautaibie X gp CI►R�€ PA 1T013 AmouM Sutaject to Tau $5,470.58 Tau Rate X 0.150 Potentiai Ta�c Due $g2p.5g NOTE': If tex payments are made within three manths of the decedenrs tlate of deaih,deduct a 5 peresnt discouni on me#a�c WiN�5%Discount{Ta�c x 0.95) $(see NOTE•1 due. Arty inheritar�ce tax due wili become delinquent nine manths after the date of de�1h. PART �� : Please check the appropNate boxes bela�v. y A �No tMx ts due. i am tfie spouaer of the deceased or I am#+a parent o#a dscedesnt who w�s 21 yeats oId ar younger at da#t of death. Proceed to SYep 2 on mverse. Do not check any otherlwxes and d'�sregard the amount shown above as Potentlal Tax Due. g �The iniamatum Is "11�e above informafion is carrect,no deduotions are being taken,and payr�nt wiH he sant correct. with my response. Pmceed to Step 2 on reverse. Dp not check any other boxes. ��The t8z rate is it�correct. 4.5°la i am a Iineai be�fiaary{parertt,chiid,grarrdchiM,etc.)of the dee8flsed. �"t{Select aorrect fau�ate at � right,and complete Part � 1�/, I am a sibling of the deceased. 3 0�reverse.) � 15°Is AII other reiationshi�{Inctudir�g none}. p ❑Changea or deductions The information above is incorcect and/or debts and deductions were paid. iisted. Compiete P�tri 2 and part 3 as spptopriafe on the back otlhis fan». E �Asset will be reported on 7he above-identified asset has laeen or will be rept�rted and tax paid with the PA Inheritance Tax inheritancs tax fbrm Return fiYed by the estgte reptesentative. FtEV-150Q. Proceed fa Sfep 2 an reverse. Da nof chack any ather bozes. Piease sign ar�d date ttse badc of the tarm when finished. P"`� Debts and Deductions z Allowable debts and deductions must meet both of the following criteria: A. The dec�dent 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 6 1/2"x 11"sheets of paper.) Date Paid Payee Description Rmount Paid Totel Enter on Line 5 of Tax Calculation $ P�'RT Tax Calculation 3 If you are ttpd�a,opr�iMn t0 the�d�te{Une 1)aCOOUM bslince(Line 2),or percent hxable{Line 3), pbrss�n a wni�omeewetlon tnbm 1116�b11ii'1�and elqch n to Mls form. 1. Enter the date the account,was established or titled as it existed at the date of death. 2. Enter the total belance of the account including any interest accrued at the date of death. 3. Ent6r the:percenieq�e o!the axo��t that is taxable tp you. a. First,deterrtrf�e the plrcerit�e owned by the decedent. i. Accounts ttiat'arefiefd in tniat for"another or others were 1009'0 owned by the dece�nt. ii. For joint accow�tc ' . mare t��e y�ar prior ro the date of death,the percen�p�t�xable is 100%diyided by the total number of owners induding the decedent. (For example:2 owners=50�0,�3 dV�rriers�33.83'"rb;''k bWhers =25%,etc.) b. Next,divide the decedenYs owried by the number of surviving owners or beneficiaries. 4. The amount subject to 4ax is datarmined bq mulGplying the account balance by the percent tauaWe. 5. Enter the totai of any debts and deductions claimed from Part 2. 6. The amount�taxable is determined by subtracting the debts and deductions from tF�e amount subject to tax. 7. Enter the qp�NbpMpte tax rete trom Step 4 b9aed o�your relgtionship ro the d8cedent: If indicaP�Si��t�X K�4�p�a � your relfltfonship to the decedent:��,�_• 1. Date EslabAshed i �1 i �t>8- 2. Account Balance 2 $ Inq�Jl � 1 � 3. PercentTaxable 3 X �� 4. Amount Subject to Tax 4 $ s'�'7��.5� 5. DeMs and Deductions 5 - 6. Amount Tazable 6 $ 5�`70�� 7. Tax Rate 7 X �..��p _ 8. Tax Due 8 $ �`fb• �� 9. With 5%Discount(Tau.x.96j 9 X oZ33, 8"] �.,�`i�R;�a cShq�afuka#ia�4�baw, Ra�m T1M0 Gom�tAted and sig�d copies ro the " of Wills tis4sd on the front of thix form, g y peymentyou are maWng. Cheeks must be made payable to" fsterof Wflls;AAertt' Do not send payment directty to the DepartmeM of Revenue. Under penalty of peryury, I declare that the facts I have reported above are true,wrtect and complete to the best of my knowledge and belief. WOrk � vY. �a ie idome 7t 7 (� - /S/ Taxpayer Signature Telephone Number Date �o as— /3 IF YOU NEED FURTFIER ASSISTANGE, CONTACT PENNSYtVAt�A DEPART'AAENT OF REVENUE DISTRICT OFFICE, C)Pi THE FIWfEfitT/CP10E TAX DIVISION AT 717-787-8327. SERVIGES FOR TAXPAYERS WITH SPECIAL HEARING AND/0R SPEAKING NEEDS ONLY: 1-800-447-3020 FB �C s�r � �� e �F A a � J O H � P b J � Y+ n.� �\ 'N•' V \````1� �J. �,/ � `ty{,! � IV iA! � r � � � � �T • �� ry . _ \ � � � � � . �`Si. � SS. a{`^ = vd •�o� ar�7ia3ewno � � 1��n:; .sr�bu��so Z� T W:s�,3� �� ,, ,� f�� _ . E.�l. . — S i �i i �� `'-' �� .�o ;c�i� � � � �_ia � _ o � t � y �� < �: M n` �u ; � my � , << .� w ; , � � § , � , x' , �� ,�,1 , , s � ,� ti_ ��