HomeMy WebLinkAbout03-18-05
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 05 ~5i
05104193
02-22-2005
REV-154!EXAFPID9-DDl
EST. OF JOHN A CONSAGRA
5.5. NO. 159-24-7363
DATE OF DEATH 09-18-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
IX] SAVINGS
o CHECKING
o TRUST
o CERTIF.
PA 17025
RENIT PAYNENT AND FDRNS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JEANETTE
164 LEANN
ENOLA
M NADOLNY
CT
I1EMBERS 1ST Feu has provided the Departllent with the infor_aHon listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above d8cedent~ you were a joint owner/beneficiary of
this account. If you feel this infor~ation is incorrect, please obtain written correction from the financial institution~ attach a COpy
to this forI! and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions lIay be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT lNSTRUCTIONS
Account No. 100854-05 Data 03-17-1989
Established
Tax
2,432.22
16.667
405.38
.045
18.24
TAXPAYER RESPONSE
:,::::',:,:,:iili~~~~ilil!~_~II!il~I!!!!~I!!I!~~~I!j~gli!!II~li!I!~gll_!ill.gj!I!I.!!I!~I~liiilll!!f:~~!!iI!!!!i
To insure proper credit to your account~ two
(2) copies of this notice IIUSt accompany your
payment to the Register of Wills. Make check
payable to: "Register of Wills~ Agent".
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you may deduct a SZ discount of the tax due.
Any inheritance tax due will becolle delinquent
nine (9) months after the date of death.
PART
[!] !~!!i~~~~~!!i!!!!~I!!I~.:,;
[CHECK ]
ONE
BLOCK
ONLY
A. The above inforllation and tax due is correct.
1. You lIay choose to rellit 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 assessllent will be issued by the PA Department of Revenue.
B. 0 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 IIUSt cOllplete PART 0 and/or PART @] below.
PART
@]
TAX RETURN - COMPUTATION OF TAX ON
LINE 1. Oat. Established 1
2. Account Balance 2
3. Percent Taxable 3 X
~. Amount Subject to Tax ~
5. Debts and Deductions 5
6. A.ount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
JOINT/TRUST ACCOUNTS
If you indicate a different tax rate 1 please state your
relationship to decedent:
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury 1 I declare that the facts I
complete to the best of .y knowledge and belief.
TA~~A~~d~(df
have reported above are truel correct
HOME (JI 7) n,,,)/1(r7{'
WORK ( )
TELEPHONE NUMBER
and
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interBst based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nins months after the decedent.s date of death.
3. A joint account is taxable Bven though the decadent's na.e was added as a matter of convenience.
~. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife _ore than one year prior to death arB not taxable.
6. Accounts held by a decedent Rin trust for~ another or others are taxable fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
L BLOCK A - If the infol"lI8tion and ccmrputation in the notice are carrect and deductions are not being claillled~ placlil an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit the. with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will Issue an official assess.ant
(Form REV-1548 EX) upon receipt of the return fro~ the Register of Wills.
2. BLOCK B - If the asset specified on this notica has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative~ place an "X" in block "8" 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 inforlllation is incorrect and/or deductions are being claimed~ check block "C" and complete Parts 2 and 3
according to tha instructions below. Sign two copies and submit the. with your check for the amount of tax payable to the Register
of Wills of the county indicated. The PA Depart_ent of Revenue will issue an official assessment (For. REV-IS48 EX) upon rsceipt
of thlil return from thlil Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the account originally was established or tJtled in tha manner exIsting at date of death.
For a decedent dying after 12/12/82: Accounts which the decedent put in joint na.es 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 number of accounts held.
If a double asterisk (MM) appears before your first name In the address portion of this notica~ the $3~000 exclusion
already has been deducted fro. the account balance as reported by the financial institution.
2. Enter the totel 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 deter_ined &s 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
E~ample: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 '= PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the na.e of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100
16.77. (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 Z {SURVIVORS) = .50
in the name of the dlilcedent and two other persons and established within one YBar of death by
X IDD
507. (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tax (line 4) is determined by lIultiplying the account balance (line 2) by the percent taxable (line 3).
S. Enter the totsl of t'- debts and dedueUons listed in Part 3.
6. The BIIIount taxable (line 6) is d.terllined by subtracting thlil debts and deductions (line 5) 'frail the allount subject to tax (1ine 4).
7. Enter the appropriate tax rate (line 7) as deter.ined below.
Date of Death Spouse Lineal Sibling Collateral
07101/94 to 12/31/94 37. 67. 157. 157.
01/01/95 to 06/30/00 07. 6% 15% 15%
07101/00 to present 0% 4.51._ 12% 15%
M' he tax rate 111posed on the net value of transfers fro'lll a deceaSild chIld twenty-one years of age Qr y
ounger at
death to or for the use of a natural parent~ an adoptive parent~ or a stepparent of the child is O~.
The lineal class of heirs includes grandparents~ parJ;mts~ chi1dren~ and lineal descendents. "Children" includes natural children
whether or not they have baen adopted by Qthers~ adopted children and step children. "Lineal descendents" includes all children of thlil
natural parents and their descendents~ whether or not they have been adopted by others~ adopted descendents and their descendants
and step-deseendants. "Siblings" are defined as individuals who have at least one parent In cOllmon with the decedent~ whether by blood
or adoption. The nCollateral" class of heirs ineludes all other beneficiaries.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deterllined as follows:
A. You legally are responsible for pay.ent~ or the estate subject to adllinistration by a p.rsonel representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of paYMent.
C. DliIIbts being clai~Bd lIust be itednd fully in Part 3. Jf additional space is needed~ use plain paper 8 1/Z" x n". Proof of
payment may be requested by the PA Depart.ent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
AEV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NADOLNY JEANETTE M
164 lEANN CT
ENOlA, PA 17025
--------Iold
ESTATE INFORMATION: SSN: 159-24-7363
FILE NUMBER: 2105-0251
DECEDENT NAME: CONSAGRA JOHN A
DATE OF PAYMENT: 03/17/2005
POSTMARK DATE: 03/10/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/18/2004
NO. CD 005076
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05104193 I $18.24
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 265
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$18.24
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 05 251
05105356
02-23-2005
REY-154J EX AFP {09-DDl
2U
EST. (IF.I~PHN A CONSAGRA
S.S. NO. 159-24-7363
DATE OF DEATH 09-18-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
[X] CHECKING
o TRUST
o CERTIF.
JEANETTE
164 LEANN
ENOLA
M NADOLNY
CT
c
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
PA 17 025
MEMBERS 1ST FCU has provided the Depart..ent with the infor.ation 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 infor.ation is incorrect, please obtain written correction from 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 Tax Laws of the Co..onwealth
of Pennsylvania. Questions lIay be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SlD~ FOR FiLING AND PAYMENT INSTRUCTIONS
Account No. 100854-11 Oat. 03-03-1989
Established
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
2,026.34
16.667
337.73
.045
15.20
To insure proper credit to your account, two
(2) copies of this notice IIUSt accompany your
paYllent to the RBgister of Wills. Make chBck
payable to: "Register of Wills, Agent".
x
NOTE: If tax pay.ents are lIade within three
(3) .onths of the decedent's datB of death,
you .ay deduct a 57. discount of the tax dUB.
Any inheritance tax dUB will beco.e dBlinquent
nine (9) months aftBr the datB of death.
Tax
PART TAXPAYER RESPONSE
[!]1!!i!~II~~l!lj!j!~liiil"I!IIII~II~!I_~!i!I!lllii!.1111.~~i~.li!j!ll!lii!_..il!II_!ill.l!i!.~!!i~.~~llli!il
A. c=J ThB above inforllation and tax due is correct.
I. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you /lay check box "A" and remrn this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. D 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. c=J The above information is incorrect and/or debts and deductions wera paid by you.
You must complete PART 0 and/or PART ~ below.
PART
@]
TAX RETURN - COMPUTATION
If you indicate a different tax rate~ please state your
relationship to decedent:
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
OF TAX ON JOINT/TRUST ACCOUNTS
lINE 1. D~te ~~t.blish.d
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. AIlount Taxable
7. Tax Rate
8. Tax Due
1
2
3 X
4
5
6
7 X
8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury~ I declare that the
c~1ete to the best of my knOWl~dge and belief.
TA~M~f~
facts I have reported above are true~ correct
HOME (1/1) 13J--lil1 Y
WORK ( )
TELEPHONE NUMBER
and
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable intBrest baslad on information
submitted by the financial institution.
2. Inhsrltence tax becomes delinquant nlna .onths after the decedent's date of death.
3. A joint account is taxable even though the decedent's na.e was added as a .atter of convenience.
4. Accounts (inCluding thasa held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointlY between husband and wife _ore than one year prior to death are not taxabla.
6. Accounts held by a de08d8nt "in trust for" another or others arB taxable fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A - If tha information and co~putation in the notice are correct and deductions are not being clai.ed~ place an nx"
in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-lS48 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 end tex paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's repres8ntative~ piece an "X" in block "Bn of Part 1 of the nTaxpayer Responsen section. Sign one
COpy Bnd return to the PA Depart~ent of Revenue, Bureau of Individual Tax8s~ Dept 280601~ Harrisburg~ PA 171Z8-0601 in the
envelops provided.
3. BLOCK C - If the notice inforMation is incorrect and/or deductions are being clai.ed~ check block "Cn and co.plete Parts Z and 3
according to the instructions below. Sign two copies and submit the. with your check for the a.ount of tax payable to the Register
of Wills of the county indicated. The PA DepartMent of Revenue will issue an official asses~ant (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 na.es 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 velue of
the account or Ule nutrber of accounts held.
If a double asterisk (MM) appears before your first name in the address portion of this notice, the $3~000 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 lor each survivor is deter_ined as follows:
A. The percent taxable for joint assets established .ore than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER Of
Jo INT OWNERS
Exa.ple: A joint asset registered
DIVIDED BY TOTAL HUHBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the name of the decedent and two other persons.
1 DIVIDED BY 3 CJOINT OWNERS) DIVIDED BY Z (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 BENE~ICIARIES
X 100
PERCENT TAXABLE
Example: JoInt account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) ~ .50
in the na_e of the decedent snd two other persons and established within one year of death by
X 1110
50X (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 4) is determined by mUltiplying the account balance Cline 2) by the percent taxable Cline 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The a_aunt taxable (line 6) is deter.lned by subtracting the debts and deductions Cline S) fro. the ~ount SUbject to tax (line 4).
7. Enter the approprIate tax rate (line 7) as deter_ined below.
Dat. of Death Spouse lineal Sibling Colliilt.,..al
07/01/9~ to 12/3l/9~ 37. 67. 15% 157.
01/01/95 to 06/30/00 0% 6% 15% 15%
07/01/00 to pr.sent 0% 4.5%_ 12% 15%
JlTnI! tax rate 111p0sed on the nBt value of transfers from a deceased chIld twenty-one years of age or y
ounger at
death to or for the use of a natural parent~ an adoptive parent~ or a stupparent of the child is DX.
The lineal class of heirs inclUdes grandparents, p8rants~ children~ end lIneal descendents. "Children" includes natural children
whether or not they have been adopted by others. adopted children and step children. "Lineal descendents" includes all children of the
natural parents and theIr descendents~ whether or not they have been adopted by others~ adopted descendents and their descendents
and step-descendants. "Siblings" ara defined as individuals who heve at least one parent in com_on with the decedent, whether by blood
or adoption. The nCollataral- class of heirs Includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deter_inad as follows:
A. You legally arB responsible 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 debts after death of the decedent and can furnish proof of pay~nt.
C. Debts being claimed gust be 1te.lzed fully in Part 3. If additional space is nQedEld~ use plain paper 8 1/2" x 11". Proof of
payment may be requested by the PA Depart_ent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NADOLNY JEANETTE M
164 lEANN CT
ENOlA, PA 17025
nnn__ fold
EST A TE INFORMATION: SSN: 159-24-7363
FILE NUMBER: 2105-0251
DECEDENT NAME: CONSAGRA JOHN A
DATE OF PAYMENT: 03/17/2005
POSTMARK DATE: 03/10/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 09/18/2004
NO. CD 005077
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05105356 I $15.20
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 264
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$15.20
GLENDA FARNER STRASBAUGH
REGISTER OF WillS