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Home My WebLink About10-25-13 (3) LOMMONWEALTH OF PENNSVLVANIA REV-1182 EX�17-96) DEPAflTMENT OF FEVENUE BUREAU OF INDIVIDUFL TA%ES OEPT.280801 HARRISBURG,PA 1]128-0801 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 018318 WOOL MICHAEL S 135 WRIGHT ROAD DILLSBURG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER __-__ ma """"'_ '__"' 13150115 � 5451 .75 ESTATE INFORMATION: SSN: � FILE NUMBER: 2113-1 133 � DECEDENT NAME: WOOL JOHN D I DATEOFPAYMENT: 10/25/2013 I POSTMARK DATE: 1 O/24/2013 I CouN7Y: CUMBERLAND � DATE OF DEATH: 09/06/2013 � � TOTAL AMOUNT PAID: 5451 .75 REMARKS: CHECK# 5177 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS flEGISTER OF WILLS . . _.. . .> _. . _._.. _.. . __._. . .. _... . . . _ _—_ _—.... i .�� oF INDIVSOWL TRXES Pennsylvania lnheritance Tax � Per�nsYivania Po wX 2eo6o1 OEPIIRTMENTOFREVENUE fWRRISlUR6 PA 1712l-0601 Information Notice And Taxpayer Response "`�-""`"""'�` ��•`�� FILE N0.21 �13-I� �J3 ACN 13150115 R�C DATE 09-25-2013 �ECisrER oF ��.�s Type of Account Z(113 OCT 25 P�I 12 ��teofJOHNDWOOL Savings SSN Checking C L E R K O F Date of Death 09-06-2013 Trust MICHAEL WOOL ORPHANS� COURTCounty.CUMBERLAND Certificate 135 WRI6HT RD DILLSBURG PA 17019-9203 ��{g�RL&MD CQ., PA MENlER3 isT Fcu provided the department with the information below indicating that at the death of the above-named decedent ou were a joint owner or baneficia of the account identified. Account No.303017 RemN PaymeM and Forms to: pete E�ab�d p3.22.2pp� REG�TER OP WILLS Account Balance $63,402.75 � �E 90UARE Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $10,567.34 Tex Rate X 0.045 NOTE': If tax paymeMS are made within three months of the Potential Tau Due $475.53 decedenYs date of death,deduct a 5 peroent discount on the tax With 5Me Discount(Tax x 0.95) $(see NOTE') due. My inheritance tax due will become delinquent nine months after the date of death. PA� �J`t@p 1 : Please check the appropriete boxes below. 1 A �No tax is due. 1 am the spouse of the deceased or I am the �rent of a decedent who was 21 years old or younger at da�of death. Proceed ro Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g �The intortnatbn is The above information is wrrect, no deduc[ions are being taken,and payment will be sent orrect. with my response. Proceed ro Step 2 on reverse. Do not check any other lwxes. C �The tau rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,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 wete paid. listed. Comp/ete€'art 2 and part 3 as appropriate on the badc of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid wiih the PA Inheritance Tax inheritance tax form Retum filed by the estate representative. REV-1500. Proceed to SYep 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. V 0 P� D�trts and Deductions s Albwable debts ar�deductions must meet boih 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 del�ts after the death of the decedent and can fumish proof of paymerrt if requested by the departmenG (If additionai space ia required,you may attach 8 1/2"x 11"shAets of paper.) Dafe Paid Payee Description Amounf Paid Total Enter on Line 5 of Tax CalcWation $ PART Tax Calculation - 3 ��b�a� it' �' dpe(LMS ��k I�CS�(��m.),a percent taxabls(Line 3)� f� 1. Enter the date the account wes establish�}or Ntled as it existed at the date of death. 2. Enter the totai balance of the account incfuding any interest accrued at the date of death. 3. Enter the pe[QeqWl�,e pf the acs�ynt that is t�ceWe to you. a. Fltbt,��`�q��,b�'tl19�ee�l@nt. i. Accounls�t"t��'M'NU�t�"en�or o#ibre were 100%owmsd by the decedent. ii. For jant acxout� ��oar prior to the date of dealh,the percentaqe taxeWe is 100%divided bY the tot8i numMr BNiri�BB i : the decOdeM. (For example:2 owners=50°Yo�3 owAb#s=�3.3396�M^oMmers =25%�etc.) b. Next,divkie tfie dec�pT�:pyr�f�pd,i�y q�e number of surviving pwnars or beneficiaries. 4. The artrount subjact to tax is de�Ma�Nd�}F��BxouM belen�by thg pers��t taxable. 5. EMgr the tot�of any�and�iw�claimed hom Part 2. 6. The ar�iDUM;ta�able ie dkermit�ed by su6dracdng ffie debts arM deducdons from the arrtount subject ro tex. 7. E+Ket=Yhe��atetttat�8�1!llMked 6r4 y0ur relationsh�Fo the !MM deCe� ,•, Ifi ., � . .,.- �:_ ytlurrel� 1. Date Eetabiiehed 1 2. Account Balance 2 $ 3. Percent Ta�cable 3 x 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5°h Discaunt(Tax x.95) 9 X al�witft�a ef��dc for��M Y�ar4�r�'I��c�s to the fippp�69r of WHIS I(sted art tk�e trot�t of:this hxm, edcs must be made payeble to"�ster of irY1Rs,Ap�rtt." Do rurt send payment directly to�e Deperbnent of Re�renue. Under penalty of pe�ury, I deciare that the� I have reported above are true,conect and complete to the best of my knowledge and belief. work '7(�- 30� - , -e"2- Flclme 7!�- Sj ir—f�c.rz o sf : T payer Sigr�ature Telephone Number Date I�' Y01J N E�D '�11 , . A'3:S'�i�1tl�, G�ITiO�CT PEIJfi1SYLVAiAIFA DEPAFiT�IfEN;i` C?� (�EaIEl�tLJE DISTRiCT OFFICE, GDFi TME' �!Jkt�Rii��kN(� TAX DIVISION AT 717-787-8327. SERVI�S FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020