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Home My WebLink About01-09-14 (5) � . dUREAU OF INDIVIDWL TAXES Penns Ivania lnheritance Tax � pennS�/LVd111a PO dOX 289601 y HARRISOURG PA 17128-0601 It1fOr111St1011 NOtIC@ DEPARTMENT OF REVENUE REV-15f3 EX DoeEXEC(�6-12) And Taxpayer Response FILE NO.2113-1205 ACN 13166441 pATE 12-04-2013 Type of Account . Estate of ROBERT L KULP Savings Che�cking Date of Death 05�23-201�� ,�� ` ;�' LLOYD KUIP County GURAB�RLAND � d��t'ficate 8D7 W TRINDLE RD � � � � MECHANICSBURG PA 17055-4058 _ , � � � � � � f." -�-# � � t� � ta � �r � � � � � � � � � � � � � � �,�. — +� : N �"' t1'� �,,. , '�t �..s C.'1 . .,. _ __,. . ..< _�. �.. . . �_ _. - _ M- __� _. ___ --- , _ . _; .. . .._.. .. .� �A �� .. , __" . ._ . - . . � :.._... _. . ._.._-. �.� .- �.+ . . '.. a i: MEMBERS isr Fcu provided the department with the information below indicating that at the death of the above-named decedent ou were a'oint owner`or beneficia af the account identified. Account No.165474 Remit Payment and Forms to: Date Establfshed 01-31-1997 REGISTER OF W1LLS Account Balance $1,924.33 7 COURTHOUSE SQllARE CARLISLE PA 1�013-, Percent Taxable - X 50 - Amount Subject#o Tax $962.17 A - � ` �� . Tax Rate X 0.045 � Potential Tax Duey,,; $43.30 � NOTE*:-If tax paymer�t&,ane;rrtadewi#hin�r�e�mor�tk�&:cyf the '`�� '``' " deceden#'s date of death,d�luct a�5 percent discount on the tax WitF�5%�iscot�nt(Tax x 0.95) $(see NOTE*) , due. Any�inh�i�tance tax due will become delinquent nine months after th�date of death. P�� t@R 1: Ples�check the appropriste boxes below. � �A �Na►'ta�c is due. I am the spous�of the deceased or I am the parent of a decedent wh�o was 21 years old or yaunger at date of death. Procaeed to St�p 2 on r�verse. Do not chedc any other boxes and disregard the amouni shawn above as Potential Tax Due. . ... . �.�..,TB_. .._.�..�--+,,...-... ..: .� ,_....r.. .� .. _. ... ........ � - - g (�Tfie ittiformati�is The above information is correct,no deductions are being taken,and payment will be sent `—'correct.T witfi my response. Proceed to Step 2 on reverse. Do not check any other boxes. C �The tax rate is incorrect. � 4.5% 1 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 �eha�g�s or�d�eductions The information above'is ineorrect and/or debts and deductions were p7aid`. � hsted. Complete Part 2 and part 3 as appropriate on the back of this form. . �Asset wilt be repor#ed a�.�-The above-identified-asset has t�een or will be repor#ed and tax paid with the PA lnher�#ance Tax E inheritance tau form Return fil�d by the es#ate representative. � REV-1500. Proceed to Step 2 on reverse. Do not check any other bvxes. 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 attach it to this form. 1. Enter the date the account was established or titlea as ii existed at ihe daie oT aeain. 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 � �� @� �� ,�� ,�,;� �� \��Q��i"".+�� '� �\�� \�� \� your relationship to the decedent: �: �`�� r � y� `� �� " � � � � �� \� �� \ �� , ��F��4��F��\\\�\\�\\\\��: 1. Date Established 1 ;�.� ��\��\\�\�`��\\��\\��\��\��\��\�\��\\ �\, � �� \�� \�\��\\\�\�\�\��\�� \\�\\�\��\ � �\�\ \��.`��\�� \ ��\��\`�\�,,�� \\\�\��\� �\�� \� �.� �� 2. Account Balance 2 $ ��:��`�;��,\�,��;��;��\��°��\��;��;� :� \� �� \\�\�\��\\\\\�\\��\��\��\\\\\�\�\\��\\��\��\\\\\\\\\\��\�\\\ 3. Percent Taxable 3 X � \ \ \ `\ \\ \ \\ \ \ \ � \ \ ��\ \ �� \ �� \��\�\�\\�� `��.��\��:��\��\�\\\\��\\��\\��\`��\��\��\�\��\�� \ \�\ �\ �� \\�� .�\��Q��\�� \\. \ � ��\\� \\� � �� \��\�� 4. /4R10Uflt SUb�eCt t0 TaX 4 , � \�� V`�A� � � �� \�� `� � � \. � �: \\ ��,`,�,��..�.��\..�`;.,�\�\�`��\��::. 5. Debts and Deductions 5 \\ \ \ \\ ��\\.: ��\�\�\�� ;��\�� \��\ \�\��\��\\: � \ �\ .\ �� \\�\\ \\ . � 6. Amount Taxable 6 $ � �� "� �� , � � \�\ \ �\�\� �� \\\� \� � � \��\� � . �� . �\ \��\ �� \\��. \ \; � ��\�� \��\\ 7. Tax Rate 7 X ` � � � ��AC�A�V� ��o �� ` �. � �� A �A��A�A�� A��\��\��AVAA�A��` VA< V. Ta� vliG Qv T � ` � > . ` �� :: � : . �� ' . : . _ � ' ��. � X , � � \. \� \ � � \� ,� � � ; ,. 9. With 5% Discount(Tax x .95) 9 � .,_;..,,,,;;,,.,.,,,,�;,�.,�,,,; �� _.. ;�� .��,� � .�� _._, ,..,�._�,_��.��..a��.��....��oA\�A��\��.�_.�.�� 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 Q 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