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Home My WebLink About01-27-14 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 018696 KNIPE KEVIN L 23 STILES DRIVE MARYSVILLE, PA 17053 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- 13163124 � S 164.26 ESTATE INFpRMATION: ssrv: � FILE NUMBER: 2113-1257 � DECEDENT NAME: KNIPE PATRICIA A � DATE OF PAYMENT: 01/27/2014 � POSTMARK DATE: 01/25/2014 ( COUNTY: CUMBERLAND � DATE OF DEATH: 10/30/2013 � � TOTAL AMOUNT PAID: S 164.26 REMARKS: CHECK# 7654 INITIALS: HMW SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES � pennsylvan�a PO BOX 280601 Pennsylvania lnheritance Tax HARRISBUR6 PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REV-1543 EX DecEXEC(�l-12) And Taxpayer Response FILE NO.21 --�j,��,57 ACN 13163124 DATE 11-19-2013 Type of Account Estate of PATRICIA A KNIPE Savings Checking Date of Death 10-30-2013 Trust K EY I N L K N I P E County CUMBERLAND Certificate 23 STILES DR MARYSVILLE PA 17053-9722 - �.,� ,-•-• ;�t � � � � � 4 C..,, �7 p � � � � t/� � � Ar rv rn � r- � rn -.� � � � �'- � .� � � � c� � _ ,�, r;�..-� , �_ "' � � ' �' � � �-�-w-- � - -� � o � � � CENTRIC BANK provided the department with the information below indicating that at the d a h of the above-named dececlent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.1036086 Date EstabNshed 12-01-1986 REGISTER QF WItLS Account Balance $7,685.00 1 COURTHOUSE S�UARE Percent Taxable X 50 CAR4tSLE PA 17013 Amount Subject to Tax $3,842.50 Tax Rate X 0.045 NOTE`: If tax paymen#s are made within tk�ree months of the Poteniial Tax Due $172.91 decedent's date of death,deduct a 5 percent discount on#he tax With 5%Discour�#'(Tax�0.95) $(see NOTE*) �� ,.2.G due. Any inheritance tax due will become delinyuent nine months �— after the date of death. PA'� Step 1: I�lease check the appropria#e boxes below. � . A ,�,Ho tax is due. 1 am the spause of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Prao�d!o Step 2 on reverse. Do not chedc any other boxes and disregarol the amount shown�above as Potential Tax Due. -- _ _ . .:--.,-��_,_..�..�__.�._�__.__.._�..,-.� .._._�:__._.,.___ _�� ,�,_�__ ---_ _.._ _- - _,� _ _. _ _ . - . _ __--- -_ _ g �e�nformation is The above information is correct, no deductions are being taken,and payment will be sen# ��r-correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. C �The tax rate is incorrect. Q 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part � 12% 1 am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). p �Changes or deductions The information abave is incorrect and/or debts and deductions were paid. listed. Complete 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 inheritar�ce tax form Refum filed by the estate represent�tive. REV-1500: Prviceed 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.) 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. ?. Enter the date the 2�ceunt wa_s Pstablish�d c�r 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%own?d 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 ��' � ��,�;,�;�'��'��`;� � � �� your relationship to the decedent: �� `��` �� ,,��;�� .� � ��'��t��\�� \� � � ��o��\��0�' 1. �at2 E$tab�l$rl@C� 1 �, � �� o\��V�`�\A\\�A��`�� . .� ��\� ��O\�� \� ��\ �\\\\�\� �� \� ��\ , �� \ � �� :� A\\ �� \� � �� :. : \ �, ��\� \\; � ��?�\ �\\\\\ ��\\�� `�� 2. Account Balance 2 $ �� ,�,�� „ �, � ��;�,� ; � ;,�� `�� \\ ��\C�\�\\�\� ��\�\�� \��\ ��\��\\� � � � �� , �\��,:� \�� \�\`�� \�\\\\\` \\��\�\ 3. Percent Taxable 3 X � , ; �� , ,��,�� ,�� ,�, �, � � �� A� ��A�� A�� \ �A �� V\A � � � \\ �\� \ \�\ \\�� \ � \��\\� \�� \�.� �� \ \�� \� \�_��\��\\��\�� \�\�\\��\�\\\ \\\\�� \��\� �; 4. Amount Subject to Tax 4 $ � ;� � � ,� y„� � �� „� �� ,� �� __�� \�\ ��\� � � \ \ ��\��\� ,� 5. Debts and Deductions 5 \ - � � , � � �� ,` �� 6. Amount Taxable 6 � � �� ;� ��.\�� \\ �\\�� \�� \ �� \ �\�\�• � 7. Tax Rate 7 X ` , . . \ �\\\, \ \ \ \ \ \ \ \ \\ \\\: ��\� �� \� ��. \` �\ ��\�� 8� Tax D�.,e 8 $ � �`� : , � � �� , � ,, X � ` � � 9. With 5% Discount (Tax x .95) 9 � � ....�� .,.._,... �.,..:.....� _..... . _. . _.._., ,.�.'...... _.,.,,., ...:.....��\�_.��..�_. 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. �, � s Work �7 I`1 - �C��C,- �`�� , Home � - '�.-� �� -��.7 :� 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 : , `; - - - - _ � - - -- _-- � - � �. � - - \^�"".� _-= - v, �- (� _ _ c� °--� - - — � . _- �-,.�`�'.. �, . -_- _- � ` - _-_ „',� -� - --_ - � ' _ : � _ : -_ __ -_. • - - _ ti . - -- - � _- � �� - -- _ -- - ;.. _ ,. .• _ - �� -- _- 4 -- - = r - _, - r - -- � - - _ - _ �.,,, . _ � : - �� . -- � _ ��. +� O E.'"' � � _- - - - i'" �j ,.Q � `� ,�.� � - _ - - '� �' Y� � � ,...J � � __ �,�, � �„" � E'� � � � _ .�- � ",�i► t,�t � -� "� -�t'i -- _ . 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