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Home My WebLink About12-30-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018599 SMALLWOOD EVELYN L 924 HAMILTON ST CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 13169981 � $102.00 ESTATE INFORMATION: ssN: � FILE NUMBER: 2113-1357 � DECEDENT NAME: FOSTER ELIZABETH J � DATE OF PAYMENT: 12/31/2013 I POSTMARK DATE: 12/30/2013 � COUNTY: CUMBERLAND � DATE OF DEATH: 04/17/2013 � � TOTAL AMOUNT PAID: $102.00 REMARKS: CHECK# 2479 INITIALS: HMW sEa� RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIYIDWIL TAXES PennsVIvania lnheritance Tax � enns Lvania PO dOX 280601 1 � � HARRISBURG PA 17128-0601 I11fOr111at1011 NOtIC@ DEPARTMENT OF REVENUE REY-154S EX DoeE (�8-�`/' • And Taxpayer Response FILE NO.2� l„�- l ACN 13169981 � DATE 12-20-2013 Type of Accoun#' Estate of ELIZABETH J FOSTER Savings SSN 177-20-5746 Checking Date of Death 04-17-2013 Trust EVELYN L SMALLWOOD County CUMBERLAND Certificate 924 HAMILTON ST CARLISLE PA 17013-1525 s�-.:; +� � �p � - "� � t� � ,� . .,.. �C � � t—'� Ct� %� ?�" W t� � �► � � ~ � � ;� � � � � . _. _ , �! �,..,�, � ""�. � , C? p '^.r� ..... - — t�? '� �...a � t? . . � ,,,,,� N �.,�, �"�t SANTaNnER B�NK provided the department with the information below indicafir�that at th�`iea�i v�the� above-named decedent you were a joint owner or beheficia of the accounf identified. Account No.1�91013587 Remit Payment and Forms to: ' Date Established 05-142001 REGISTER OF WILLS Account Balance $4,532.52 1 COURTHOUSE SQUARE Percent Taxable X 50 CAR�ISLE PA 17013 Amount Subject to Tax $2,266.26 Tax Rate X 0.150 Potential Ta�c Due $338.94 NOTE*: If tax payments:are made within,three months of the dececi�nt's date of death,deduct a 5:percent discvunt on the tax With 5%Discount(Tax x 0:95j $(see NOTE•) due. Any inheritance tax due will become detinquent nine morrths _ after the date of.death. : Pa� S��p 1: Pl�ase check the�ppropriate boxes below. � A �No tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who was 21 years old or younger at date of death. Proceed fo Step�on reverse. Do not chedc any other boxes and disregar�d the amount • .;shown at�ove as Potential Tax Due. ` __ _ . . , -- --. �__ _ ._.:...�.�..,�--.- - B the'infiormation�is ✓ ��e above in�or'mation is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on neverse. Do not check any other boxes. C �Th�tax rate is incocrecE. �� 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part � �2% 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. Complefe Pa�t 2 and part 3 as appropriate.on the back of this form. E �Asset will be reported on The above-ident�fied asset h�s beer�or will be reported and tax paid with the PA Inheritance Te�c mheritance tax f�rm Retum fil�d by the estate representative. REV-1500. Proceed,to Step 2 on reverse. Do nvt check ar�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), �izas�abtain a v✓ritte�correcti��from ti�e fina�cial ir�stitutio��nd atta�h it to this f��m. 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, pleas tate �� ' �� : � � > � your relationship to the decedent: E� � . � , � � � � �;� ��; � � �'��'�� : . � � ��. �� 1. Date Established 1 � �_ ,: ' � ��\�V� �� \.` � , � � �� 2. Account Balance 2 $ U��a� �� '� � ` � � �� \\� �� \ � � � \� \��\`. / V � : � \�� .� 3. Percent Taxable 3 X � � � � � \��\ \ \ � � � � � � \ ,\\\\\: 4. Amount Subject to Tax 4 $ �d ��•d� �G' �� „ , �� , � � � � ; 5. Debts and Deductions 5 - �) �; � � ; � , � , ,,: ,� � � ' �� , � � _ 6. Amount Taxable 6 $ � �� '• � � � � � � �� ! � � � � . ; � �� \ � .� �\� \��\\� � �� ;�. 7. Tax Rate 7 X CJ�(� �` � � � ` � � � � � � � . _ . , , , , , 8. Tax Due 8 $ � � �'�- � �� , � , ; �3 .,. � �� 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 L�. ,, �,, Home ��'�--r�4�� .. ;��1 l�� Taxpayer Signature Telephone Number Date r z 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 -mi�p . — �III'A1R � . — ,..,��:�� . . — a:.:_.. . r . . t� �� `, - _ -- �� R _ _ - � ��T►� - � ,�� ` ,�� _ - _ - 31 �� 2 - - - - _ ..,S 3 ��,� - - - �� .: �� - __ - _ - CL� ��-� - � - t}R��A�� p., �� - - - _ �� --- - _ - - �U - - _ _- ,,� • - - - ! - - - - �►. �, - - •.t _- - � -- _ _ �� - - _ _ t� ' _ _ - � , _ _ _ � � - - - �� - - t�1 � . � — –_ - - _ ' �'� _ - _ �' � — _ – - I� �. - _ - i� - � N � � .� - - �. g � .� _ - �. - -� � - _ � � "°' �. __ � � c,,� � �� - ..�+�. ;� y� ,3 - ,� �T - w�r. . . . . . . �✓� . . � � � �¢ � . .. � . � . � . � �'� - - — � � — �� • — .. '� � . . . ' � "� — wM� _ � — � � — — �` � � y — �. � . . .. � '� �� w� �� ! ✓ 'i''' •`,`' .. - .'"..... - - - ...� "�, _ - _ � ? _ �� z` - - � - - „�•,.,,, � - _ «.... _ - Y'�.► �.: , _ � i -