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Home My WebLink About11-19-13 B�R�,o oF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 HARRISBURG PA 17128-0601 ICIfOfI7latIOC1 NOtIC@ ` DEPARTMENT OF REVENUE And Taxpayer Response RE�-=543 EX DocE%EL <o8-�z� FILE NO.2113-0874 ACN 13145955 � ^�='";;� Q� DATE 08-30-2013 �'��i:r� t1� �;'�� ' .1�� 19 �i� �{ TYpe of Account ``'i� jy ' Est Y�of WILLIAM C ZIMMERMAN SSN 165-16-3899 Savings G L.E t�K ��i= Date of Death 08-04-2013 Checking SCOTT D ZIMMERMAN ntyCUMBERLAND X Trust 90 ONEIDA RD �R��t�� a r� CertifiCate CAMP HILL PA 17011-677b C��$ER��"�� r. ��{ CITIZENS BANK OF PENNSYLVANIA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.6236794239 Remit Payment and Forms to: Date Established 10-02-2012 REGISTER OF WILLS Account Balance $ 1,000.20 7 COURTHOUSE SQUARE Percent Taxable X 100 CARLISLE PA 17013 Amount Subject to Tax $ 1,000.20 Tax Rate X 0.150 Potential Tax Due $ 150.03 NOTE*: If tax payments are made within three months of the With 5%Discount(Tax x 0.95) $(see NOTE*) decedenYs date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I 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 check any other boxes and disregard the amount shown above as Potentia/Tax Due. B �The intormation 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 incorrect. � 4.5% I am a lineal beneficiary(parent, child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% 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. Comp/ete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will 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. � 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.) Pa ee Description Amount Paid Date Paid Y Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation � If ou are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), Y -- piease obtain a written correction from the financiai insiiiution and ainacn it io this orm. 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 ta�cable 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. �I byrthe totalcnumber of olwners ncl d ng the de edent r(Forhexamplef 2 o ne se p50%n3 ownersbl 33.33°%/4 o n e�rs =25%,etc.) b. Next,divide the decedenYs 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: ` � � 1. Date Established 1 �'�` 2. Account Balance 2 $ � �� 3 X �, �, . :, ' 3. Percent Taxable � 4. Amount Subject to Tax 4 � �'��` 5. Debts and Deductions 5 " �� ° ` � � � �� 6. Amount Taxable 6 � �.�� X � � �a� ��o � � _ „�� \�� 7. Tax Rate �"�`� `�`�`� � ;�� ` � � � �� 8 $ � 8. Tax Due �� ` ' � �� _ �� :�� :. �� , , , , � g. 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 1(?-7�7- 71R�— � �� Home �l /. axpayer ig ture Telephone Number ate IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE fiAX DNISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pe1111S�/LVdlllcl PO BOX 280601 HARRISBURG PA 17128-0601 Information Notice ` DEPARTMENT OF REVENUE And Taxpayer Response ' REV-1543 EX UocEXEL �oa-,z, FILE NO.2113-0874 ACN 13145954 �'�'� ��=`�<"� ' DATE 08-30-2013 ��5 t��t ��' .: kt._S �'(j13 ��ll� �� ,�jJ� �j �(� TypeofAccount state of WILLIAM C ZIMMERMAN Savings SSN 165-16-3899 X Checking HENRIETTA S ZIMMERMAN c�'�� ' Date of Death 08-04-2013 Trust 90 ONEIDA RD �Ri�F�QE1� �Qu��,�' CountyCUMBERLAND Certificate CAMP HILL PA i�oii-6��Mg��At�p G^'��.�., P�� CITIZENS BANK oF PENNSYLVANIA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.6100683672 Remit Payment and Forms to: Date Established 06-06-1966 REGISTER OF WILLS Account Balance $35,700.73 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $17,850.37 Tax Rate X 0.150 Potential Tax Due $2,677.56 NOTE*: If tax payments are made within three months of the With 5%Discount(Tax x 0.95) $(see NOTE*) decedenYs date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. A []No tax is due. I 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 check any other boxes and disregard the amount shown above as Potential Tax Due. B ��he information is 7he 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 incorrect. � 4.5% I am a lineal beneficiary(parent, child, grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part � 12% 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. Comp/ete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will 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�evers�.-_Do not check any other boxes. Please sign and date the back of the form when finished. i 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 firom the financiai institution and a�iach ii�o t�iis form. 1. Enter the daal bala ce of the accotu nl ince dinglany nterest accrued attheedate oftdeath. 2. Enter the to 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 a Icnumber of oiwners nclud ng the decedent r(Forhexamplef 2 o ne se p50%n3 ownersbl 33.33°%/4 o w eas by the tota =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficianes. 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: � ` 1. Date Established 1 � 2. Account Balance 2 � 3 X .A� � � �� 3. Percent Taxable �� ; �' � 4. Amount Subject to Tax 4 $ \ _ ,�, <. 5. Debts and Deductions 5 ��- � ' g. Amount Taxable 6 $ a ' : 7 . Tax Rats � X \� �F��.oe\r\ ��., ��. �ti�a� ..� � ��\ 8. Tax Due $ � �,� . ' : �: �s � �� .� g. With 5%Discount(Tax x .95) 9 X Step 2: Sign and date be�mentRotu areTmaOk g Che ks musgbed ade payable oegReg ste ofIWillseAge the Donnot se d�rm, along with a check for any pay Y 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 �17-737-Ry�� Home � Taxpayer Signa e I��Q Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTA T DIV S ON LATN717-7g7 gg2MEN SERVICESEFOR DISTRICT OFFICE, OR THE INHERITANCE TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020