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Home My WebLink About11-04-13 BI�EAU OF INDIVIDWL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 DEPARTMENT OF REVfNUE HARRISHlNt6 PA ��z$-o6o� Information Notice REY-lSi3 EX DocEXEG(�8-12) And Taxpayer Response FILE NO.2113-0989 � ACN 13156708 DATE 10-25-2013 Type of A�cbunt,. . �t� � .. Estate of ANNIE G PATTISON Savings , Checking Date of Death 09-05-2013 r.:. T t BRUCf A WYR I CK County CUMBERLAND ,� �• � � 'ficate 7 E WALNUT ST � , LEBAi�ION PA 17042-5476 ;� � � C'� ,��, m �' c� � cn � � � . . � �,. � � ��, m �, � � � � � � � � ra � �; � '*� � t-�, o -�-; �-�:. �° c� � �--a �.,, �' ; �, F,...:. ��, � ; ;:.�u..a.ti. ---_� ...d,...��..:_v.—_–• ,...:_,z; •�n,q;,.�.>�..: �,,..w-.�i+� - _.�.�.. __ .. ,�.. , .._ s . - � --_ . . ....s-_ � - --�.: `�t�r.., ��....�.x+:r=:.�.+.::»<..ye�a,��a+- *r¢��-�;., . �:.:.M:w - �2� . - �. . .._. .... � . -� � . . . ,. � . .��"' __.+�� .�, . ....._.._ _, C_�TIZENS BA�IK OF PENNSYLVANIA provided the departmen#with the information below indicating�hat at #he death of the above-named decedent ou were a'oint owner or bEnefici of the account identi�ed. Ren�it Paym�nt and Forms to: _ .,�acp�w��l�..&��t��77 � � � � � � � �� : � .:�:;:��,.� _ � � � : . �.� .:b�..�. -- - - - T TER OF WIL�.S :. . -- ....�,.w ....:. REGIS Account Balance ��E�t1ARE '$35,611.32 . ._.:....,. .�. � Percent Taxable �CARLI '� PA 17013: _ X 50 Amount Subject to Tax ` $17,805.66 _ � Tax Rate X 0.150 . ` NOTE*: If tax payments ace r��de within three mo�tths�t�f Nt� Potential Tax Due $2,670_85 - ��er�'�.ciate of death,d'ed�ct a 5 percent discouc�t i�t�e tax --er . Wifh 5�o t�iscount(Tax x 0.9�),; $(see NOTE;� due. Any inheritance fax due rnrill become delinquent�i�ie-r�ti�hths after the dat�of death. . -- . , PART _ � '�t�p 1: Pl�ase check the appropriate boxes below. .� ,.. , A ��#��c�is due. I am the spouse of the deceased or 1 am the p�rent bf a d�ced�en�wrho was 21 years old or yownger at date of death. �'rooee+a►i`a St�v 2 on reverse. Do not check any other boxes and di.sregarol�t�e amount - shQ�arrs above as Potential Tax�ue. _ , �_�_ �__ . 2 t x �{�:'___ _� <"-��,�t;�, �, � � ;:,; Y : �`� : . , ...� _�._... i ..�,;:k ��.�w't:�� V..r.. . � � � : �'v�►�'ic�'i� ` e��e rr�rrr�a�m�correc,no-�eductions are being taken,and payment wiii�e sent ��= with m re nse. � Y � Proceed fo Step 2 on reverse. Do not check any other boxes. - � �The ta�c rate is inct�rrect.' ' Q 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.j of the deceased. (�elect cor�rec�,.tax_ra#e at - right,a�d complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). p �sh�tr�es or deductions The informatlon above is Pncorrect and/or debts and deduGtions were paid. ; � � ; Comp/ete Part 2 ana►part 3 as appropna#�on the,hack pf th�s form. E � A�sef wiil be reported on The above-iderl#i#ied asset has been or will be reported and fa�c:paid with the PA Int�$ritan�e Tax inhe�it�anc�e`ta�c form � Retum�iied by the estate representative. ,. � � ' ....� �4.. ,...� .. y. REV-1500. Proceed to Step 2 on r+everse. Do not cfa�cck an,y 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), pleacp abtain a written correction frorr�th�financial institution and attach it to 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 t�tal number of owners including the decedent. (For example:2 owners=50%,3 ov�ners=33.33%, 4 owners =25%,etc.) b. Next,divide the decedent's percentage owned ny 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: , ; ; \ �`��3��1��'�� ` �� . � 1. Date Established 1 � � � � �� ` �_ � ' � �; ��`� � ,�� , �� ` �� 2. Account Balance 2 � �� : . � � � � � ,� , � � �, ,, � , � � � 3. Percent Taxable 3 X � ` � �� 4. Amount Subject to Tax 4 $ �� ' � � , , ,..,.., ,.,: ..: � 5. Debts and Deductions 5 - � �� , � ; , � � 6. Amount Taxable 6 � � � � � ' ` ! �� , ,,�, ,, ` , ; , � � 7. Tax Rate � X �, ; . ,.�� ; �\ \ �\,��, , ,\\\� , � � 8. Tax Due 8 � � � � , � , �� ,� ��,� ,�„ � : � ,�, � �� ,� , �,, �.: �� :..��.... , ..�'�... .,_ ...��.... . :.,.......: ......,.:..... ..��..,,. .::�.... 9. With 5% Discount(Tax x .95) 9 X � �� 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 ` `� � Home d� , Taxpayer 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