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Home My WebLink About11-14-18 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018413 MCKILLOP LESLEY G 4 FEHERVARI CT SOMERSET, NJ 08873 ACN ASSESSMENT AMOUNT CONTROL NUMBER -----°- fold ---------- -------- 13159174 � $621 .42 ESTATE INFORMATION: ssN: � FILE NUMBER: 2113-1228 I DECEDENT NAME: MCKILLOP JOHN R � DATE OF PAYMENT: 11/18/2013 ( POSTMARK DATE: 11/14/2013 I COUNTY: CUMBERLAND � DATE OF DEATH: 10/13/2013 � � TOTAL AMOUNT PAID: 5621 .42 REMARKS: CHECK# 101 INITIALS: HMW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDWL TAXES Penns Ivania lnheritance Tax � enns Lvania PO BOX 280601 Y p y HARRISSI�G PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Respon$e RE"-'S`3 EX°°`EXE``.°-'2' FILE NO.21'-'�� ACN 13159174 DATE 10-31-2013 . Type of Acxount fstate of JOHN R MCKILLOP Savings SSN 098- Checking Date of Death 10-13-2013 �C� Trust LESLEY MCKILLOP County CUMBERLAND ° Certificate 4 FEHERVARI CT �.. SOMERSET NJ 08873-6203 � � ;p � t Q � � � � �`? '� ' rn � � � � � � � � � �'' � � v'» � ,Q' c> �► `n -n � � � � '� � ;, � � � � rn � - � __ . __ _ � � -- � -�.� . � � � � � FULTON BANK NA provided the department with the in�ormation below indicating that at the death of the abov�-nam�!decedent you were a joint owner or beneficiary of the account identified. A�ccouht No.3625 Remtt Payment and Forms to: Date Established 05-25-2011 REGISTER OF WILLS Account Balance $14,536.20 7 COURT`�OUSE SQUARE Percent Taxabie X 100 CARLISLE P/4 17013 Amount Subject to Tax $14,536.20 Tax Rate X 0.045 Po�ential Tax Due ��4.1� NOTE*: If tax payments are made within three months of the With 5°/a Disco�nf .ax x 0.95 * decedent's date of death,deduct a 5 percent discount on the tax Cr ) ��s�e IVOTE . .2. due. Any inheritance tau due will�becorne deliru�uent nine months after the date of death. PA� �tGp 1: Pie�se check the appropriate boxes below. 1 A Q No ta�c is due. t am the spouse of the deceased or I am the parent of a decedent who was 2 1 yeacs o l d or younger at date of death. Pro�.�ee�d to 5'tep 2 on r�everse. Do not chedc any other boxes and dis�gard the amount shown above as Potentia/Tax 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. C �The tax rate is incorreci. �4.5% I am a lineal beneficiary(parent,,�hild,grandchild,etc.)of the deceased. (Select correct ta�c rate at right,and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). . - . . � ,` ,. p o��eductions� T in�oyr� io is incofrect and/or debts and deduetions�w.e�_�e p�id. `�:� �. f" �� , ► �-� �''tC.� le�b�2 and rt 3 as ro riate on h `. ,. �..�-��,..�,.,i"�t � z � P a a P P P t e�c k c�h r s fi o n n. , . � :. E ��SS�will be reported on The above-identified asset has been or will be reported.and ta�c paid with the PA Inheritance Tax : � - inheritance tax farm F�etum filed by the'estate representative. ° ` R�V-1500. Proceed to Step 2 on reverse. Do nof check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Aliowable debts and deductions must meet both of the fol�owing 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 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 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 indicatin a different tax rate, lease state . �c,= �� \ ��,�� ` � ,� ; 9 P �� your relationship to the decedent. � � ��: � � � � , ��,��.� ; , 1 �. : �� ; �,� �� , � 1. Date Established �� ; , � � �. ; � � ; � �; �`��, ; � , � 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 rr+aking. 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` � � � �%gg � �'� , Home 3 . � <! DI Taxpa r Signature Telephone Number ate 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