HomeMy WebLinkAbout10-28-13 LOMMONWEALTH Of PENNSVLVFNIA REV-1162 EX�11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIOUALTAXES .
DEPT.280801
HARRISBURG,PA 17128-0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 018331
HALL ISAIAH S
PO BOX 136
PLAINFIELD, PA 17081-0136
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
------- ,oa
--------- --------
13149032 � 822.89
ESTATE INFORMATION: SSN: �
FILE NUMBER: 2113-1 142 �
DECEDEN7 NAME: GEIST KENNETH L �
DATEOFPAYMENT: 10/28/2013 I
POSTMARK DATE: 1 O/27/2013 I
CouNTV: CUMBERLAND �
DATE OF DEATH: 06/1 O/2013 �
�
TOTAL AMOUNT PAID: 522.89
REMARKS: RECEIPT TO ATTY
CHECK# 951
INITIALS: CJ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
°�° � Z�m=Y��u"L T.uc�� Pennsylvania lnfieritance Tax � ���'S��v����
PO pOX 2pD601
lukRlslUR6 PA ]7128•O60] Information Notice DEPARTMENTOFREVENUE
And Ta�cpayer Resqqnse R`�-'�6"�"�"<".�"
FILE N0.21 -!�j'!(4'L,.
ACN i3149032
R E C 0 R U�C� ;� ;`;,".`� �}p� DATE 09-20-2013
.. o ;.i� Of ';'. :`,?_S
�u�� ��v� �8 �' � (^ Type aP Accaunt
� �sta`{e oY�ENNETN E GEIST Savings
G L�;:ti t�p�y�o Oeath 14-2013 �Trustking
ISAIAH S HALL ORPHANS� C:�3Q}�'�'�UMBERLAND Certificate
ro aox ias CllMBERLAE#U Gtt.. PA,
PLAINFIELD PA 1�tl82-q136
. . . . . , . _ . _ _ . . . ._ . . ..._.. . . ., . ��.s
SOVEltE2CM s�x providet!the department with the infarmation below indicating that at tMe deaih at the
abave-named decedent ou were a 'oint owner or benefiaia of the account identified.
Account No.1877077792 Remft Paym�M and farma to:
DgM9 Estabii�hed qS-26-2006 REGISTER OF WIILS
Account 8ala�ce $345.15 7 COURTMOU3E SQUARE
Parcent Taxable X 50
CARLI3�E PA T70iS
Amount Subject to Tax $!52,58
Tau Rate X 0.150 ��_. ��������made within d7ree morrths of tha
Potenriel Tax Rue $22.89 decadenY�date of death,deduct a 5 percent discourn on the ta�c
With 5°/n DiSCOUnt{Tex x 4.95) $(ses NOTE•} d�. My inheritarice iarc due wi)i become delinquent nine manths
aRer the date of death.
PA� St9�3 1 : Ple�se check the approprlate boxes below.
1
A �Na#ax is due. I am the spouser of#he deceaaed or I am ther par�nt of a deaedent who was
21 yesrs old or your�er at date of death.
Proceed to Step 2 on reverse. Do not chedc any pther boxes and disregard the amounf
,,_ shown abo�as_Patential Ta<'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.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child,grandchild, etc.)ot the deceased.
{Select cwrect ta�c rate at
right,and camplete Part � 12°�, I am a sibling of[he deceased.
3 on reverse.}
� 15% All qther relationships{including none).
p ❑Changes or deductians The infarmaiion a6ave is incorrect andtor debts a�!deductians were paid.
iisted. Camplete Part 2 and part 3 ss appropdate an the back oi this form.
E �Asset will be reported on The above-identified asset has been or wfll be reported and tax paid with the PA Inheritance Tax
inheri[ance tau form Return fiied by the estate representative.
REV-1500. Proceed to Step 2 an reverse. Do not checic any other boxes.
Piease sign and date the back of the form when finished. �
PA� �ebts and Deductions
x
Aliowable debts and dedud3ona mu&t meet b�of the foflowing criteria:
A. The decedet�t was fegalEy responsible tor payment,and the estate is insuff�ient to pay the deductible items.
' B. You pa4d tMe de�s after the deeth ef the decederrt and can fumish proof of payme�t if requasted by the department.
, (It addftrona!space�requited,You may att�h 81l2"x 11"st�eets of paper.)
date Paid Payee descriptian Am4unt Paid
Total EMer on Line 5 of Ta�c Caiculatian $
PART Tax Calcutation
�... � �Dlwr `oM�� �ri �'������a.2),or Pen�rnt taanbis tLins�3,
' t. Enter the date the fl�xount was established or iit4ad as it exia�ted at the date of death.
2 Enter the totsl ba�ns�e o#d�e a�xxYUnt ind�r�any irrter�t accrued at the date pf death.
3. Enter the percerdape of tlie�count that is taxable to you.
a: Fxak,�=�9er Cnn»d by tho deCadent:
� i. Accau�tUsi q►6 h8kt"ir�t�t for"anoMyer or'Odwrs w6re 100%owneCl by th9 de�ced9nt.
;
ii. For jant acxo tnpr8, ort�year pria to tl7e date ot deatA,the percentege ts�c�tte is 160%divided
bY the tatal nu�` ^' iri��e decedeM. (For example:2 owners=50%�3owrfe�a�33:33Yw 4 ovmers
j =25%�etc.j
' b. Next,divide the dececl�lt'8�i aMT�d by the number of surviving owners or berreficiseies:
� v,•`` +s."� 'r
� 4. Ths amourK subject ta ta�t�s t�ppNA�by rru�6ptyic�g the accaunt bsiarr�e by the pereent taxable.
� 5. Enter the total ofi any detrts and ded�+cUona claimed from Part 2.
.� 6. The amourd t�abfe fa�by subtracting the debts and deduCtions from the atrwurrt subject Eo te�c.
, 7. Et�the , , �c r&{4xfrc�s,��r t b8sed on yOUr r8 ' ' i�tt�de�Ct•
'_ If"a�a dHferark'�rmm.pib�e�'
; ycwr r9tatbhahip ta
=; 1. Date Established t
i 2. Account Balance P $
� 3. Percent 7axabie 3 X
4. Amount Subject to Tax 4 S
5. peMs and Deducttons 5 -
6. Amount Taxable 8 S
'_ ?. T�Aste ? X
- _ 8. Tax Due 8 S
9. With 5%Discount(Ta�c x .95) 9 X
_ � 2: Sign and date bq�aw• ReWrn ili�J corr�atecl and sipned copies to tkre Rap'Wsr of Wilis lis�d an the front of this form,
aksng wkh a cheds tdr�Y�a+vat Y�are m�irq. Gfiecks must tae matle payafste to"�iegfater of VV4ka;Apent." Do nnt send '
payment direetly to the DepaM»tK Of Revenue.
Under penaRy ot perjury, i declare that the facts t have r8port8d at�ove are true,COflBCt 9tid COrt�fIBt810 fh8 Y?BSt flF ffly IU10WI8dQ8 SM)
bBflB1.
l����� / Work
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Taacpayrer 5i,gttature Teiephone Nut� Date
e" tF YOU NEECS FUA'i'1't�R A�s`�P�'t'A�t+IC�. CONTACT i'��1ik18�LVa�filA D�FAFiTiWEFiT t?F R�1dEt+#UE
�, DISTRICT OFFIGE, OR THE IN1kdERlT,0.Iti1�E TAX DIVISlQN A"f 717-787-8327. SEFtVICES FOR
.4�'' TAXPAYERS WITH SPECIAi. HEAf31NG AN�fOR SPEAKiNG NEEDS ONLY: t-800-447-3020
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