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Home My WebLink About03-03-05 . , " , . \ f/ / If I( III . I r r- -.. ..~ ~~~. ""\ l:) .?~ ::/-'2. 0::: - ""'--- -=' 'k f'J a <$J '-, '''I ~ J ~ il . l , , I ~ " -- o r-- I VlWf :' I.. -r- _' , fOil') - '\) ..~ :N-'-j t'l....M- i -J. If) C- f11Nf f?j!!1~ r";'I 3 C" 1')- n() ii"\1t 1!1(;~'L..) ell ;;);.:n'_,' nr...10i" . \ ,~ C ,- r'A -f J c5 ~-f - r!1 .- :J - J(J(l Uo-.g~ j.. It' .... (}! - QI -rJ...- till. 0 . at [. -:i 0/ J rv (Y.'UtJ - - - - - - -:: - - -,~ () (I) f') "'-, f') .,. l-' {":. ..... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG# PA 17128-0601 *: INFORMATION NOTICE .. ...... .1'ND "AXF'AVI::iR(~ES PONS E FILE ACN DATE NO. 21 05 doG 05103089 02-18-2005 REV.lSUEXAFP 109-00l 3 iStl2:o~grIMOTHY E ADAMS S.S. NO. 209-36-9059 ~ATE OF DEATH 02-17-2004 rCOllff:l'l'Y CUMBERLAND TYPE OF ACCOUNT o SAVINGS IX] CHECKING o TRUST o CERTIF. IVA L ADAMS 152 S 31ST ST CAMP HILL PA 17011 REHIT PAYHENT AND FDRHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYPOINT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent# YOU were a joint owner/beneficIary of this account. If you feel this information is incorrect# please obtain written correction from the financial institution# attach a copy to this forM and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3100006200 Date 09-01-1998 Established x 7,502.00 50.000 3,751.00 .045 168.80 To insure proper credit to your account# two (l) copies of this notice MUst acco.pany your payment to the Register of Wills. Make check payable to: ~Register of Wills# Agentn. Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax paYMents are lIadewithin three (3) Months 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. Tax PART TAXPAYER RESPONSE [!][;i[;!~~~~.lli!.!II!~!i!!a~I!I!i!_~!I!!~I!!I!.!II!.~1i~g!!!!!~~I!!i!.I!~..!!!I.I!I!i~g!!i!.~~!!!!I.I~I!!!!I!l [CHECK ] ONE BLOCK ONLY A. The above inforMation and tax due is correct. 1. You may 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 ~An and return this notice to the Register of Wills and an official asseSSMent will be issued by the PA Department of Revenue. B. c=J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. 0 The above inforMation is incorrect and/or debts and deductions were paid by you. You Must co.plete PART 0 and/or PART ~ below. LINE 1. Daie Esiabli$had 2. Account Balance 3. Percent Taxable 4. AMount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 PART [!] TAX RETURN - COMPUTATION If you indicate 8 different tax rate, please state your relationship to decedent: PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax CODPutation) Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and b.li.f. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicabb lnbarest based on inforllatian submitted by the financial institution. 2. Inheritance tax becomes dslinqusnt nine .onths after the decedent's date of death. 3. A joint account is taxable Bven though the decedent's na_e was added as a .attar of convenience. 4. Accounts (including those held betwBsn husband and wife) which the decedent put in joint names within one year prior to death are fully taxable 8S transfers. 5. Accounts established jointly betwBen husband and wife .ore than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust forn another or others are taxable fully. REPORTING INSTRUCTIONS PART 1 TAXPAYER RESPONSE 1. BLOCK A - If tha information and computation in the notice are correct and deductions are not being clailled, place an "X" in block "An of Part I of the "Taxpayer Response" section. Sign two copies and subllit thell with your check for the allount of tax to the Register of Wills of the county indicated. The PA Departllent of Revenue will issue an official assessllent (Forll REY-1548 EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has bean or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block lOB" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Departllent of Revenue, Bureau of Individual Taxes, Oept 280601, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being claimed, check block "C" and cOllplete Parts 2 and 3 according to the instructions below. Sign two copies and subllit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Departllent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originallY was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint nalles within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the nUllber of accounts held. If a double asterisk (MM) appears before your first nalle in the address portion of this notice, the $3,000 exclusion already has been deducted froll the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued 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 BY TOTAL NUMBER OF JOINT OWNERS Example: A joint asset registered DIYIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIYING JOINT OWNERS in the nalle of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIYORS) - .167 X 100 16.72 (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent"s death or accounts owned by the decedent but held In trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Exallple: Joint account registered the decedent. 1 DIVIDED BY 2 (SURVIYORS) = .50 in the nalle of the decedent and two other persons and established within one year of death by X 100 502 (TAXABLE FOR EACH SURVIVOR) 4. The allount subject to tax (line 4) is deter.ined by .ultiplying the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The allount taxable (line 6) is deterllined by subtracting the debts and deductions (line 5) fro. the amount subject to taM: (line 4). 7. Enter the appropriate tax rate (line 7) as deterllined below. MThe tax rate lllposed on the net valua of transfers froll a deceased chIld twenty one years of aga or youngar at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 02. The lineal class of heirs includes grandparents, parents, children, and linesl descendents. "Children" includes natural children whether or not they hava been adoptad by others, adopted children and step children. "lineal descendents" includes all children Df the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and thair descendants and step-descendants. nSiblings" are defined as individuals who have at least one parent in COllllon with the decedent, whathar by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Dat. of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3X 6X 15X I.5X 01/01/95 to 06/30/00 OX 6X 15X 15X 07/01/00 to present OX 4..5X- 12X 15X - CLAIMEO DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are dater.ined as follows: A. You legally are responsible for paYllent, or the estate subject to administration by a personal reprasentative is insufficient to pay the deductible itells. B. You actually paid the debts after death of the dlllcedent and can furnish proof of paYllent. C. Debts being clailled Must be ite.ized fully in Part 3. If additional space is needed, use plain paper 8 1/2" x 11". Proof of pay.ent lIay be requested by the PA Depart.ant of Revenue. COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D601 - INFORMATION NOTICE '.Ct~)<PAYIo~~~~S PONS E FILE NO. 21 oS dCJu ACN 05103090 DATE 02-18-2005 REY-I&4J EX AFP (09-DDl 7 TYPE OF ACCOUNT ,: lsfrlliF l:fi.!OTHY E ADAMS Iil SAVINGS 5.5. NO. 209-36-9059 o CHECKING 0, cilAr~ OF DEATH 02-17-2004 0 TRUST \~"\'ehliN.1l1Y'c CUMBERLAND 0 CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 IVA 152 5 31ST CAMP HILL L ADAMS ST PA 17011 WAYPOINT BANK has provided the Dapart.ant with the infor.ation listed balow which has bellln usad in calculating the potantial tax dua. Their records indicata that at the daath of the abova decedant, you ware a joint ownar/benaficiary of this account. If you feel this information is incorrect, please obtain written correction fro. the financial institution, attach a copy to this for. and return it to the abova addrass. This account is taxable in accordance with the Inheritanca Tax Laws of the Commonwealth of Pennsylvania. Questions .ay be answared by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING ANu PAYMENT INSTRUCTIONS Account No. 3160000324 Date 09-30-1998 Established x 3,917.58 50.000 1,958.79 .045 88.15 To insure proper credit to your account, two (Z) copies of this notice .ust acco.pany your pay.ent to the Register of Wills. Make check payabla to: ~Registar of Wills, Agant~. Account Balance Percent Taxable A.ount Subject to Tax Rate Potential Tax Due x NOTE: If tax pay.ents are .ade within three (3) months of tha decedant's date of death, you may deduct a 5X discount of the tax due. Any inheritance tax due will become delinquent nine (9) .onths after the date of death. Tex PART TAXPAYER RESPONSE [!]t1~illl~~.im.iili"iilil~~~ljii!_~ijii!~II!li.!I!I.~'~.il!ill.III__!III..ilillljli!~~I!i!I~1!f:~~l [CHECK ] ONE BLOCK ONLY A. D The above information and tax due is correct. 1. You .ay choose to r~it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay check box ~A~ and return this notice to tha Register of Wills and an official assess.ant will bill issuad by the PA Department of Revenue. B. 0 Tha above asset has been or will be reported and tax paid with tha Pennsylvania Inharitance Tax return to be filed by the decedent"s representative. C. D The above information is incorrect and/or debts and deductions wera paid by you. You must cOlllplBte PART 0 and/or PART ~ balow. LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Anount Subject to Tax s. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due 1 2 3 X 4 5 6 7 X 8 PART @] TAX RETURN - COMPUTATION If you indicate a different tax rate} please state your relationship to decedent: OF TAX ON JOINT/TRUST ACCOUNTS PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury} I declare that the facts I have reported above are true} correct and co.plete to the best of my 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 on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent"s date of death. 3. A joint account is taxable aven though the decedent's na~s was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint na.as within one year prior to death are fully taxable as transfers. 5. Accounts establishsd jointly between husband and wife .ore than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully, REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the infor.ation and co.putetion in the notice are correct and deductions are not being clailled~ place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and subldt the. with your check for the a.ount of tax to the Register of Wills of the county indicated. The PA Depart.ant of Revenue will issue an official assass.liH1t (Form REV-1548 EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent"s representative~ place an .oX" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one COpy and return to the PA Department of Revenue~ Bureau of Individual Taxes~ Dept 280601~ Harrisburg~ PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice infor.ation is incorrect and/or deductions are being clai.ed~ check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and sub. it them with your check for the a.ount of tax payable to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or tItled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint n~es within one (1) year of taxable fully as transfers. However~ there is an exclusion not to exceed $3~OOO per transferee regardless the account or the number of accounts held. death are of the value of If a double asterisk (..) appears before your first n~e in the address portion of this notice~ the $3~OOO exclusion already has been deducted fro. the account balance as reported by the financial institution. 2. Enter the total balance of the account inclUding interest accrued 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 .ore than one year prior to the decedent's death: I DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exa.ple: A joint asset registered DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 16.7~ (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent"s death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered thB decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 in the na.e of the decedent and two other persons and established within one year of death by X 100 50~ (TAXABLE FOR EACH SURVIVOR) 4. The allount subject to tax (line 4) is deter.ined by MUltiplying the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of thB debts and deductions listed in Part 3. 6. The amount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) fro. the amount subject to tax (line 4). 7. EntBr the appropriate tax ratB (line 7) as detBrmined below. dBath to or for the use of a natural parBnt~ an adoptive parent~ or R stepparBnt of the child is O~. The lineel class of heirs includes grandparents~ parents~ childrBn~ and lineal descendents. ftChildren" includes natural children whether or not they havB beBn adoptBd by others~ edopted children and stBP children. "LinBal descendents" includes all children of the natural parents and their descendents~ whether or not thBY have been adopted by others~ adoptBd descendents and their desCBndants and step-descendants. "Siblings" are defined as individuals who havB at IBast onB parent in com.on with the decedent~ whether by blood or adoption. The "Collateral" class of heirs includes all other benBficiaries. Date of Death Spouse lineal Sibling Collateral 07101/94 to 12/31/94 3r. 6r. lSr. lSr. 01/01/9S to 06/30/00 Or. 6r. lSr. lSr. 07101/00 to present Or. 4.Sr._ 12r. lSr. -The tax rate i.posed on the not value of transfers from a decBBsed Chlld tWBnty-one years of age Dr y ounger at CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsiblB for pay.ent, or the estate SUbject to ad.inistration by a personal representative is insufficient to pay the deductible items. B. You actually paid the dBbts after death of the decBdent and can furnish proof of pay..nt. C. Debts being claimed must b. it..ized fully in Part 3. If additional space is needed~ use plain paper 8 1/2" x 11n. Proof of pay.ent may bB requested by the PA Depart.ent of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARHISBURG, PA 17128-0601 AEV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ADAMS IV A l 152 S 31 ST ST CAMP Hill, PA 17011 -- fold EST A TE INFORMATION: SSN: 209-36-9059 FILE NUMBER: 2105-0200 DECEDENT NAME: ADAMS TIMOTHY E DATE OF PAYMENT: 03/03/2005 POSTMARK DATE: 03/02/2005 COUNTY: CUMBERLAND DATE OF DEATH: 02/17/2004 NO. CD 005017 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05103089 I $168.80 05103090 I $88.15 I I I I I I I TOTAL AMOUNT PAID: $256.95 REMARKS: CHECK# 922 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WillS