HomeMy WebLinkAbout03-25-14 (2) BUREAU 28 INDIVIDUAL TAXES Pennsylvania,Inheritance Tax ennS lvania
BU EAU 280601
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
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RECORDED 0 EIS dOTlaxpayerResponse E.0.,W[FILENO.21 — 114 Z-7-3
REGISTER 07 WILLS ACN14111732
DATE 03.07-2014
2014 N 25 Pal 12 25
CLERK OF Type of Account
Estate of
Checking
CUMBERLAND CO., Ply Date of Death 02.23-2014 Trust
MICHAEL CARPENTER
2822 W ROSEGARDEN BLVD County CUMBERLAND Certificate
MECHANICSBURG PA 17055-5313
MEMBERS 1ST FCU provided the department With the information below indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.72914 Remit Payment and Farms to:
Date Established 03-09.2000 REGISTER OF WILLS
Account Balance $18,943.72 1 COURTHOUSE SQUARE
Percent Taxable X 16.667 CARLISLE PA 17013
Amount Subject to Tax $3,157.35
Tax Rate X 0.045
Potential Tax Due $142.08 NOTE*: If tax payments are made within three months of the
With 50%Discount(Tax x 0,95 due. A ti's date of death,deduct a 5 percent discount on the tax
$ see NOTE" 7.1C1
}_ due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1
A [:]No taxis due. i am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
-g-[_X_J The infcrmatton is - - The above Information is conect,no deductions are being taken,and payment will be sent
correct, with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C ❑The tax rate is incorrect. F-] 4.5% 1 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% Ail other relationships(including none).
D Changes or deductions The information above 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
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed 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 81/2"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 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%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 different tax rate, lease state
g p Official Use Only ❑AAF �
your relationship to the decedent: PA Department of Revenue
1. Date Established 1
2. Account Balance 2 $ PAD
3. Percent Taxable 3 x 2 1
4. Amount Subject to Tax 4 $ 3
5. Debts and Deductions 5 - 4
6. Amount Taxable 6 $ 5
_ 7. Tax Rate_ 7 x 6
8. Tax Due 8 $
8
9. With 5%Discount (Tax x .95) 9 x
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.
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Taxpa er 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