HomeMy WebLinkAbout10-25-13 COMMONWEALTH OF PENNSVLVANIA REV-1162 EX�11-98�
DEPARTMENT OFFEVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280801
HAPqISBURG,PA 1]128-0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 018316
WOOLS MICHAEL S
135 WRIGHT ROAD
DILLSBURG, PA 17019
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
------- ,o�a
---------- --------
13150119 � 51 ,161 .21
ESTATE INFORMATION: SSN: I
FILE NUMBER: 2113-1 133 �
DECEDENT NAME: WOOL JOHN D I
DATEOFPAYMENT: 10/25/2013 �
POSTMARK DATE: 10/25/2013 I
CouNTY: CUMBERLAND �
DATE OFDEATH: 09/06/2013 I
�
TOTAL AMOUNT PAID: $1 ,161 .21
REMARKS:
CHECK# 5180
INITIALS: CJ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BURFAU OF INDIVIDWL T�ES Pennsylvania lnheritance Tax ' � Pen�sylvania
Po !ox 2BO6u1 DEPARTMENT OF REVENUE
VWiRISBURG PA 17128-0601 Information Notice
And Taxpayer Response "`�."•,"""�E� �•• ���
FILE N0.21�13'/I 3�j
ACN 13150119
DATE 09-25-2013
RE615TER OF F�II.l�S
Type of Account
t013 OCT 25 P� ! 12 �� EstateofJOHNDWOOL �Savings
SSN Checking
C L E R K O P Date of Death 09-06-2013 rrust
MICHAEL WOOL CountyCUMBERLAND Certificate
135 WRIGHT RD HANS' COURT
DILLSBURG PA 17019���ERLAND G4„ P�i „
MEkIERS isr Fcu provided the department with the information�befow indicating that at the death of the
above-named decedent you were a'oint owner or beneficia of the account identified.
RemR Paymsnt arW Forms to:
AccouM No.303M�
Date EstabNShed 07-31-2007 HEGISTER OF WILLS
Account Balance $162 973.61 � �URT���ARE
CARLISLE PA 17013
Percent Taxable X 16.667
Amount Subject to Tax $27,162.81
Tax Rate X 0.045
Potential Tax Due $1,222.33 NOTE`: If tax paymeMS are made within three months of the
deoedent's date of death,deduct a 5 peroent discount on the tax
With 5%Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine months
after the date of death.
PA� St@p 1: Plea�check the approprlate boxes below.
�
A �No tax is due. 1 am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not chedc any other boxes and disregard the amount
shown above as Potential Taz Due.
g �The intormation is The above infortnation is correct, no deductions are being taken,and payment will be sent
�ortect. with my response.
Proceed to SYep 2 on reverse. Do not check any other boxes.
� �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,9randchild,etc.)of the deceased.
(Select cortect tax rate at
right,and complete Part � �p/, I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
lis[ed. Complete Part 2 aM part 3 as appropriate on the back of this lorm.
E �Asset will be reported on The above-identified asset has been or witl be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished. �
P"� Det�ts and Deductions
z
Aiiowabfe�ant!daductions must rt�eet both of the foilowirp criteria:
A. The deced�tt was legaliy responsibie#or paymerrt,and the estate is insufi�ieM to pay the deductibie ftems.
B. You peid the debts after the death of the decedent and can furnish proof ofpayment it requested by the department.
{If additionai spaoe is reqahed,you may attach 81/2"x 11"sheets of peper,)
Date Peid Payee Description Amount Pekl
Total Enter�Une 5 of Tax Cakxaiatiori $
PART Tau Calcul�#ion
3 �a�t a w�Nl #� ; . Lt,i�a ��CIIiCh��s�2},tn Percw�t#a�cabio{I.Ine S}:
1. Enter the date the account was eskat�liehed or titled as it existed at the date of death.
2. Enter ths tatal balance ot the acxaunt including any intereat accrued at the dafe of death.
3. EMer tlae of tlsa account tl�i¢twcable to ya�.
a. F'vst,Qe���rrttiii+b drrei^ " c�iq�lby thB.d�deM.
i. AGapurNS'thflt er�heM'Mh"ti�t tbr"anot�er w others were 10096 ovw»d by thedecedent.
ii. For oint �at�-gesr�iar to the date of de�h,the taxat�Ie is t{k}�'a d'evicfQd
by�totsi number oC owme�s in �e decedent. {For exampie:2 awners=50%,3 owh�s�33.339R;4 ov�ners
=a��,,e�c.�
b. Next,divide iM decedp�t'1t qW�l:by the number of survivirp owciprs,or.beneficfaries.
A. The amcwrrt aubjeci to ta�c is �Y iawllp�yinq the aceount 6aiance isy ihe perCerrt tanabie.
5. Enterthe tafai af any dsbts ar�d deductions ciaimed ftom Part 2.
6. Trie anaunt taxaErle is dMermined by su�ractinq the debts and deductions hom the nmount subject to ta�c.
7. EMer t!»approp�s�cak'���b�sed aa-yww re�eNonsh4p tu the trt.
!ti Ei,. � ��A4M> ' ` ��� �
your reP onehp�to e dece�it:
1. Date Esfebliehed 1
2. Account Bslar�ce 2 �
3. Percent Taxable 3 X
4. Amount Subjectlo Tax 4 $
6. E7ebts a�d dedactions 5 -
6. Amount Taxable 6 $
7. Ta�c flabe 7 X
8. Tau Due 8 S
9. With 6%Discount(Tax x..95) 9 x
alor�p`xtth�a ohedc�anY�sRymqnt you are�fi$.'Checks mu�ade payab e ta later V�4i�Agenf.�" t)o noise�nd�,
payment dfrectly to Ure Dqpatlm9M of Revenue.
Ur�r p�alty of per�ury,f dacl�re fhat the facffi i have reportgd above are Wa„correct and corr�ete ta the best of my knowledge and
tteiief.
WOrk 'T!7- 3+'��11c+�+Z
Na[ne 7 t7- �.2.Sr""5�2.-" t+x ,��tt
Taxpayer ignature Teiephane Number Date
iF Y4U NEED FLtRTF1�Fi A3SiST�1t�'�, :G€�i3`RGT I���f3.Y.AP1�A DEPAF!"�'1ti1�t+tT OF REY£NUE
C?}STRICT {}FFiCE, OR TF#E iNF#�RI"�A�GE TAX F3lVR4fa1V AT 71?-787-8327. SERti�(�ES FOR
7AXPAYERS WITH SPECIAL HEARING AND/OR SPERKING NEEDS ONLY: 1-80p-447-3020