HomeMy WebLinkAbout02-24-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*.
INFORMATION NOTICE
AND
V4~PA~~R RESPONSE
FILE
ACN
DATE
NO. 21 OS J8D
04146313
12-14-2004
RE'f-1S"UAFP (Gf,.aJl
:EJ:;TZIJIF STACEY R MASON
5.5. NO. 072-48-1967
DATE OF DEATH 10-06-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IXJ CERTlF.
SARA A MASON
135 WINSTON DR
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FUL rON BANK has provided the tlepartllent with the inforllation listed below which has been used in
calculating the potential tax due. Their rBcords indicate that at the death of the above dBcedent~ you were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect~ please obtain written correction fro. the financial institution~ attach a COpy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance T~ laws of the Co..onwealth
OT Penn$ylvenie. Question5 .ay be an$wGrad by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . .
Aooount No. 022-0172600
. SEE REVERSE SIDE FOR
Oat. 03-09-2002
Established
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable X
A.ount Subject to Tax
Tax Rate X
Pot.ential Tax Due
1,263.57
16.667
210.60
.15
31. 59
To insure proper credit to your account~ two
(2) copies of this notice must aCCOMpany YOur
payment to the Register of Wills. Make check
payable to. "Register of Wills~ Agent".
NOTE: If tax payments are .ade within three
(3) months of the decedent's date of death~
YOU /lay deduct a 57. di~nt of the tax due.
Any inheritance tax due will b8~e delinquent
nine (9) .onths after the data of death.
PART TAXPAYER RESPONSE
m_-,",f'fRfPJ_.pJr_I'~ltl!!'.'lr~1
jl\j~;._.;!~_..,j~]i~r~m;...,., _..,.,_._.;:".,_....,:._,_,!ni._..(,.:_..::~lj:i!,.,_._"",'_",~. .~!:[.ji:iil;~~~~~":_....,;\l;~~L.~.,""~~..::,,.:..,::\;~~~i~~t..,." .,.,.,'_....,.,_}ll~~jJj:i!if~~~j
!~r~ijfii!~r~:._:..}ijf~~i~!L.:_I~i:fij;
".,.,.,,,,,.,~ ",."",,,.,,,.,,,,,.,.,,,,,.,.,,,,,.,.,.,~,,.,., "'.'.""'.'.' ""'.'" "",.,.,~.,.,.,~".,~ "':<.' ""'.,.,,,,'.... .. ".,."",.,.,.,.,.,."""""""',,.'~",',""''','''''.'.'' "".,.,.,,,.,.,.,,,
.,.,.,,,,,., ""'.''''','.'.'''.'.'.' ,,,,,., "','"-""',,,,.""',"""'., ",,,,, ""'.'",,,"',,,""','-""'.'.,,,,,,,.,... :<.,;"",.,.,."",.""",.,.,,,.,.,,,,,,,,
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The abovo inforaation and tax due is correct.
1. You lIay choose. to rBlllit p!lYlUlnt to the Register of Wills wi th two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Depart.ent of Revenue.
B. 0 The above asset has been or will be reported and tax paid with the Pennsylvania InheritBnClil Tax return
to be filed by the decedent's representative.
c. 0 The above infor.ation is incorrect and/or debts and deductions ware paid by you.
You must co~lete. PART m and/or PART 0 below.
PART
~
TAX RETURN - COMPUTATION OF
lINE 1. Oat. Established 1
2. Account Balance 2
3. Percent Taxable 3
4. A.aunt Subject to Tax 4
5. Debts and Deductions 5
6. A.ount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
x
x
PART
[!J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of rax COBPut.tion)
I
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
cORPlete to the best of By knowledge and belief.
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
TAXPAYER SIGNATURE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based an infaNnetion
sua-ittad by ths financial institution.
Z. InhlilritancQ tax b8COlIeS dslinqulilnt nine months after the decedent's dab of death.
3. A joint account is taxable even though the decedent's name was added as a .atter of convenienc8.
4. Accounts (including those held betwusn hUsband and wife) which the decedent put in joint names within one year prior to
death ara ~lly taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or othar'S are taxable fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A - If the infor~ation and co.putation in the notice are correct and deductions arB not brain; clai.ed, place an "Xh
in block "Ah of Part 1 of the ""Taxpayer Response" section. Sign two copies and subtKit thlhl with your check far the a.aunt of
tax to the Register of Wills of the county indicated. The PA Dapart.ent of Revenue will issue 8n official assesSlent
(FQr~ REV-lS48 EXJ upon receipt of the return froN the Register of Wills.
Z. BLOCK! - If the asset spscified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by th9 decedent's rrapresantativa, place an "X" in block "BOO af Part I of the "Taxpayar Responsa" section. Sign one
copy and return to the PA Department of RevBnue~ Bureau of Individual Taxes~ Dapt 280601~ Harrisburg, PA 17128-0601 in the
envelopa providBd.
3. BLOCK C - If the notice information is lncorrect and/or deductions are blaling clailllEld, ch.ck block "c" and co.plebl Parts 2 and 3
according to the instructions bBlow. Sign two copies and ~it theN with your check for the a.aunt of tax payable to the RBgister
of Wills of tha county indicated. Tha PA DepartNent of Revenue will issue an official asseSSMent (ForN REV-l548 EX) upon receipt
of thll return from the Ragister of wills.
LINE
1. Entar
NOTE:
TAX RETURN - PART
2
TAX COMPUTATION
the date the account originally was established or titled in the Nenner existing at date of IhIsth.
Far a decedent dying after 12/12/82: Accounts whieh the decedant put in joint naNes within one (1) year of death are
taxable fully as transfers. However, there is an e>tclusion not to 8xceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double ast8risk (.M) appears before your first nsae in the address portion of this notlee, the $3~OOO exclusion
already has been deducted from thlal account balance as reportgd by the financial institution.
2. Enter thB total balance of the account including intsrast accrued to the date of daath.
3. The percrant of the account that is taxabla for eeeh survivor Is det.r.ined as follows:
A. The percant taxabla for joint assets established 1I0re than ons year prior to thB decedent~s death:
1 DIVIDED BY TOTAL NUMBER DF
JOINT OWNERS
Exallple: A joint asset reg1stsrad
DIVIDED BV TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the nSllra of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100
16.7Z (TAXABLE FOR EACH SURVIVDRJ
B. The percent taxable for assets created within one yaar of tha decedent"s death or accounts ownad by tha decedent but held
in trust for another indIvIdual(sJ (trust beneficiarias):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS DR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
fxa~18: Joint account registerad
tha decedent.
1 DIVIDED BY 2 (SURVIVORSJ = .50
in the naMe of the decedent end two other persons and established within one Yea~ of death by
X 100
502 (TAXABLE FOR EACH SURVIVORJ
4. The ~ount subject to tax (line 4) is dater.ined by Multiplying the account balance (line 2J by the percent taxable (line 3>.
5. Enter the total of the debts and deductions listed in Part 3.
6. The a.ount taxabb (line 6) is detel'lIined by subtraeting the debts and daductions (line 5> fro. tha a.ount SUbject to tax Cline 4J.
7. Enter the appropriate tax rate (line 71 as deter.insd below.
Dat. of Death Spouse Linaal Sibling Coll.terel
07/01/94 to 12/31/9~ 3% 6% 15% 15%
01/01195 to 06/30/00 0% 6? 15% 15?
07101/00 to present 0% 4.5%- 12% 15%
Mine tax rete I.posed an the not vaJ.ue o' transfers fr~ 8 deceased Ch1ld twentY-anti years Df age or y
ounger at
dBsth to or for the use of a natural parent, an adoptj"e psrent~ or e stapparant of the ohUd is 07..
The l1nes1 class of heirs includes grandparent$~ parents~ children, and lineal dascendents. "Children" includas natural children
whether or not they haVB bean adopted by others, adopted children and step children. "Lings] descendents.. includes all children of the
natural parents and their descfmdants~ whgther or not ths~ have been adopted by o'thers, adopted descandents and their desc:endMts
and step-descendants. "Siblings" are dafinad as indI"iduals who hava at lesst ana parent in coamon with the decedent~ whather by blDod
or adoption. The "Collateral" cll!lsS of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART
:;
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deter.ined as follows:
A. You legallY are rasponsJble for pay.ent~ or the estate subject to ad.inistration by a personal representati". is insufficient
to pay the dsductible ite.s.
B. You actually paid the debts after death of the decedent and can fUrnish proof of paYDent.
C. Debts being claj.Bd lIlust be it_i;zsd fully in Part 3. If IJdditional spacs is needed, use plain paper 8 1/2'" x 11". Proof of
payllent .ay be requasted by the PA Departlllent of Revenue.
COMMCJ.NWEAlTH OF PENNSYLVANIA
DEPARTMENT Of REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG, PA 17128-0601
AEV-1162 EX(11-961
RECEIVED FROM:
PENNSYl VANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MASON SARA A
135 WINSTON DR
MECHANICSBURG, PA 17055
-------- fold
ESTATE INFORMATION: SSN: 072-48~ 1967
FilE NUMBER: 2105-0180
DECEDENT NAME: MASON STACEY
DATE OF PAYMENT: 02/23/2005
POSTMARK DATE: 02/23/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/06/2004
NO. CD 004983
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04146313 I $31.59
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$31.59
REMARKS:
CHECK# 4013
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
8UREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG~ PA 17128-0601
_tM_._
~':
INFORMATION NOTICE
. AND
.r~XPAYER RESPONSE
FILE
ACN
DATE
NO. 21 05 j 80
04146312
12-14-2004
RfV-l!i4!l:XAFP {n-DDl
. ~~2;JlF STACEY R MASON
5.5. NO. 072-48-1967
DATE OF DEATH 10-06-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
lXJ CERTIF .
CHRISTOPH S MASON
135 WINSTON DR
MECHANICSBURG PA 17055
REHIT PAYHENT AND FDRHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FUL TON BANK h.. providod tho Dopartmont with tho information listod bolow which has boon usod in
calculoting tho potontlol tax duo. Thoir rocords indicato that at tho doath of tho abovo docodont, YOU woro a joint ownor/bonoficiary of
this account. If yOU fool this information is incorroct, ploaso obtain writton corroctlon from tho financial institution, attach a copy
to this for. and roturn It to tho abovo addross. This account is taxablo In accordonco with tho lnhoritanco Tax Lows of tho Coooonwoalth
o~ PennsYlvania. Questions .ay be ~nswered by calling (717) 787-83?7.
COMPLETE PART 1 BELOW .
Account No. 022-0172600
. . SEE
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
Date
Established
REVERSE SIDE FOR
03-09-2002
FILING AND PAYMENT INSTRUCTIONS
x
1,263.57
16.667
210.60
.15
31.59
TAXPAYER RESPONSE
To insure proper credit to your account~ two
(2) copies o~ this notice ~ust accompany your
pay_ent to the Register of Wills. Make check
payable to: ftRegister o~ Wills~ Agentft.
x
NOTE: I~ tax paY_ents are !lade within three
(3) _onths of the decedent's date of death~
YOU may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
PART
m
..
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
o The abOVe in~ormation and tax due is correct.
1. You .ay chOose to remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ or YOU may check box "Aft and return this notice to the Register o~
Wills and an official assessment will be issued by the PA Depart_ent of Revenue.
o Tho abovo assot has boon or will bo roportod and tox paid with tho PonnsYlvanla Inhoritanco Tax roturn
to be filed by the decedent's representative.
If you indicate a different tax rate} please state your
relationship to decedent:
o The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Oete Established
2. Account Balance
3. Percent Taxable
4. Amount SUbject to Tax
5. Debts end Deductions
6. Amount Texable
7. Tax Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3
4
5
6
7
8
x
x
PART
@J
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computat10n>
$
TAXPAYER SIGNATURE
HOME (
WORK (
TElEPHONE
)
)
NUMBER
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with appJicabls interest based on inforMation
sub.ittsd by the financial institution.
Z. Inheritance ta~ becgges delinquent nine Nonths aftsr ths decedent's date of death.
3. A Joint account is ta~ab18 even though the decedent.s na.8 WBS added as a matter of convenience.
4. Accounts (including those held betwBsn husband and wife) which tha decedent put in joint na.es within one ~8ar prior to
death are fully taxable as transfers.
5. Accounts established jointlY between husband and wife .ore than ons year prior to daath ara not taxable.
6. Accounts held by a decedent -in trust for" another Dr others 8re taxable fullY.
REPORTING INSTRUCTIONS - PART
1
- TAXPAVER RESPONSE
1. BLOCK A - If the information and computation In tha notice are correct and deductions are not being c18i.ed~ place an "X"
in block "An of Part 1 of the "Taxpayer RssponSB" section. Sign two caples and sub_it t~ with your check for the a.ount of
tax to the Register of Hills of the county indicated. The PA Depart.snt of Rsvenue will issue an official aSseSSMent
(Form REV-IS48 EX) upon receipt of the return from the Register of Hills.
2. BLOCK B - If the asset specified on this notice has been or will bs reported and tax paid with the Psnnsylvania Inheritance
Tax Return filed by the dacedsnt's representative~ place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
coPy and return to the PA Department of Rev8nue~ Bureau of Individual Taxbs~ Dept Z80601, Harrisburg~ PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice infor.ation is incorrect and/or dBductions are being clai..d, check block "Cn and complete Parts 2 and 3
according to the instructions below. Sign two copies and sub.it them with your chack for the a.aunt of tax payable to the Registe~
of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-IS48 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the accoont originally was established or titled in the ..anner existing at date of death.
For a decedent dying after 12/12/8Z: Accounts which the decBdent put in joint naNes within 008 (1) year of death are
taxable fullY as transfers. However, there is an exclusion not to exceed $~~ODD per transferee regardless of the value of
the account or the nuaber of Rccounts held.
If a double asterisk CMM) appears before your first n8MB in the addrsss portion of this notice~ the $3~ODQ exclusIon
al~eady has been dsducted fro. the account balance as reported by the financial instltu~ion.
Z. Enter the total balance of the account including interest accruad to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets establIshed more than one year prior to the decedent"s death:
1 DIVIDED BV TOTAL NUMBER OF
JOINT OWNERS
Ex~le: A joint asset registered
DIVIDED IV TOTAL HUMBER OF X 100 PERCENT TAXABLE
SURVIVING .IOINT OWNERS
In the nallle of the decedent and two other persons.
1 DIVIDED BV ~ (JOINT OWNERS) DIVIDED 8Y 2 (SURVIVORS) = .167 K 100
16.72 (TAXABLE FOR EACH SURVIVOR)
8. The percent taxable for assets created within one year of the decedent's death or accounts owned by the dClcsdent but held
in trust for another individualCs) (trust beneficiaries);
1 DIVIDED BV TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
E~a~ple: Joint account reQistsred
the decedent.
1 DIVIDED BV 2 {SURVIVORS) = .SO
in the nB1Ul of the dscedent and two other persons and sstabli$hed within one year of death by
X loa
5D% CTAXABlE FOR EACH SURVIVOR)
4. The amount sUbjsct to tex (line 4) is detenlined b~ ~ltiplying the account balance (line 2) by the percent ta~eble (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The BIIount taxabie Cline 6) is deter.ined by sUbtrecting th& debts and deductions CUne 5) from the $llIount subject to tax (lins 4).
7. Enter the appropriate tax rate Cline 7) Bs deter.ined below.
po ounger at
death to or for the U$e of a natural pa~ent~ an adoptive parent.. or a stepparent of the child is OZ.
The lineal class of' heJrs includes grandparents~ paN!nts~ children.. and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted chJldren and step children. "lineal descendents" includes all children of the
natural parents and their d.scendents~ whether or not they have been adopted by others.. adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the d.cllildent~ whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
o.t. of Death SPO\ls. Lineal Sibling Coll.t.rtll
07101/94 to 12/31/94 37. 67. 157. 157.
01/01/95 to 06/30/00 07. 6% 157. 157.
07/01/00 to p~.s.nt 07. 4..57._ 127. 157.
_The tax rate t. sed on the not value of transfers fr~ a deceased chifd twenty-one years of age or Y
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
A. You legally are responsible for payment.. or ths estate subject to ad.inistration by a personal representative is insufficient
to pay the deductible Items.
B. You aetuallY paid the debts after death of the decedent and can furnish proof of paYlllent.
C. Debts being claiMed MUst be itemized fully in Part 3. If additional spacs is needed.. use plain paper 8 1/2" x II". Proof of
paYlllant lIay be requested by ths PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17126-0501
AEV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MASON CHRISTOPHER S
135 WINSTON DR
MECHANICSBURG, PA 17055
nn____ fOld
ESTATE INFORMATION: SSN: 072-48-1967
FilE NUMBER: 2105-0180
DECEDENT NAME: MASON STACEY
DATE OF PAYMENT: 02/23/2005
POSTMARK DATE; 02/23/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/06/2004
NO. CD 004982
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04146312 I $31.59
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$31.59
REMARKS:
CHECK# 4102
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS