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Home My WebLink About10-30-13 (2) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11-96) BUREAU OF INDIVIDUAL TAXES DEPT.280601 = HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018345 GROUP GARY 1940 STERRETTS GAP AVE CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 13155802 � $51 .74 ESTATE INFORMATaON: sstv: I FILE NUMBER: 2113-1 151 I DECEDENT NAME: GROUP GEORGE R I DATE OF PAYMENT: 10/31/2013 I POSTMARK DATE: 10/30/2013 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/18/2013 I � TOTAL AMOUNT PAID: S51 .74 REMARKS: CHECK# 631 1 INITIALS: HMW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS �u��►u oF �Nn�v�n�►� TAxES Pennsylvania lnheritance Tax � pennsylvania 0 BOX 2so601 DEPARTMENT OF REVENUE HARRISBURG PA ��28-060� Information Notice An��v��Q� ��ncQ REY-1543 EX DxEXEG(/8-12) �a,. � ,�� ,�'� FILE NO.21"" ' ACN 13155802 DATE 10-22-2013 � Type of Account Estate of GEORGE R QROUP Savings Checking Date of Death 09-18-2013 Trust GARY GROUP County CUMBERLAND `C�rtificate 1940 �STERRETTS GAP AYE � CARLISLE PA 17013-],Ob2 c^,, :-.�-=-' � C w � i"�! C� t� '� �"" � '�"� _ ._.. . -- . _. _ � _ _ .:.:.. _ . , .._^__. .. ,.� c:� .t}"� , - - - �► . , - rn � c-,, - _-� �,n av . � � � � � �� , � :� � PN� aANK N� provided the department with the information below indicating thai�#�e,�eatlt��. of t� '° ~n above-named decedent ou were a joint owner or beneficia of th� account ide i .�� . � � �� _. Account No.5130318255 Remit Payment and Fornns ta� -�-t '�` �... ►"'� 7i:� tU Cn c3 Date EstabNshed 04-01-1978 REGISTER OF WILLS � �''f Account Balance $7,261.64 7 COURTHOUSE SAUARE Percent Taxabte X 16.667 � CARLISLE PA 17Q73 Amount Subject to Tax $1,210.30 ' Tax Rate X 0.045 Potential Tax Due NOTE*: If tax payments are made within three months of the $54.1t6 dececlerrt's date of death,deduct a.5 percent discount on the tax With 59�o Discount(Tax x 0.95) $�sse NOTE'`) ,$'/�'7� due. Any inheritance tax due will become delinquent nine months after the date of death. PA� �rt@p 1: Rle�se c�c the appropriate boxes below. � . , . a [�1�10 t�x is�due. , 1�am#he spouge o#the deceased or 1 am the parent of a decedent who was 21 �ears old or.younger at date of death. � � `Pr,+�c�eed to Step;2 on revec�e. Do not chedc any other boxes and disnegard the amount 'shown�bove as Fotentia!i'ax Due. _.._.. _.�_»�_..�.._--_._.---__ ------_ g��T��he in��rm2�tiort is The above information is correct, no deductions are being taken,and payment will be sent f—�correct. ��•F�-'---` with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C �The ta�c rate is incomect. - � 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at . right,and complete Part � �p�o 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. listed. Complete Part 2 and part 3 as appropriafe on the back of this form. E �Asset will be reported on The above-identified asset has beert or wi11 be reported and tax paid�rvith the PA Inheritance Tax mheritance tax form Return f�led�by the estate representative. REV-1500. P�eed to Step 2 on reverse. �not�heeh 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 financial institution and at#ach it#o this form. 1. Enter the date the account was established or titled as it existed at the date of 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: � �� .' � . � ��r�� 1. Date Established 1 �;< ��, , �� , � , � �� .: .. � � �� ` � 2. Account Balance 2 $ �`�� < �\ X � , ; , � ' �: � .� 3. Percent Taxable 3 � � _�. ., � � : 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% Discount(Tax x .95) 9 X ' � \ ,, �: � � ...�. ti..s.:, � .. �. ..,.,...._.."..,�.� ,._ _,_. ._,�, ,,,,,,,,,,,,,a�_N, ti�� 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 �7/'%- 2�.s-�-5�� < Home Q --�`r- 2�',�� Taxpa er Signature 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