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Home My WebLink About04-14-14 (2) COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 1 71 2 8-0601 � PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 019017 WENGER JESSICA S 44 FOXANNA DRIVE CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold """"" """" 14106957 � $289.03 ESTATE INFORMATION: SSN: � 14106958 � 5141 .26 FILE NUMBER: 2114-0057 I �ECE�ErvT NannE: HARRY EDWARD F � DATE OF PAYMENT: 04/14/2014 I POSTMARK DATE: 04/1 1/2014 I couNrY: CUMBERLAND � DATE OF DEATH: 01/02/2014 I � TOTAL AMOUNT PAID: 5430.29 REMARKS: RECEIPT TO ATTY CHECK# 183 INITIALS: CJ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS - � CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG,PA 17055 GEORGE M.NOUCK TELEPHONE (717) 766-0209 (1912-1991) /� /�`G2�!/!i [ FAX (717) 795-7473 �/7- rv � -.� � M _ , � � � � � '/f� 'V � C� � �<��!' `�i�G� �a�C� � ,�,, �--- �, --i C:1 � � rn �� ?? � � -� � c� ��,�,�/ --- �"- �' `� ° � � � Q � ...,� -,� l � � � � � � � � � � N � rn �� /76l3 � ra� cf, o � d�.� ��'1 • � ��r�� . � a l- i�- Ga 57 U-� �. � ,�..e-r, : � %�.ec�.0 y� �u �G(� �-r�rn�r �e .' ��u/ �- �-��s �� S. �� iYG' /3Q�� ^ �� - ��.�� , G� � . �.. � �.�.,t.�.� �%�►� .�..�� . ��..� � � n . C!/ �� 1,t,W"' <t GG / j '2�� v �/ . � � ' �y, � am.��-t`� a a•�s ��u�r c� �� c�r� , . � ,.�u�,� ��,�►a� ��- � ��. �� ,�y�, � �� , �� y� � � - � , ,�,�� ; ��"'� � �� BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax �� pennS�/LVa111d - Pd'BOX 280601 ' DEPARTMENT OF REVENUE HARRISBUR6 PA 17128-0601 Information Notice � ''' ""'�� REV-1543 E1(DocE%EC (OB-12) And Taxpayer Response FILE NO.21140057 ACN 14106957 �E C �D��. �.F�� . � DATE 02-10-2014 REGIST�� ,�= �';!l.LS 2014 A�R 1`f �� Type of Account te of EDWARD F HARRY Savings Checking ��.�i��i �� Date of Death 01-02-2014 Trust JESSICA S WENGER ORP�IQ�S' ��R'�ountyCUMBERLAND X Certificate 224 KEY WEST BLVD CARtISLE PA 17015-8546 GUMBE�LA'�D CO.� PA PNC BANK NA 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. Remit Payment and Forms to: Account No.31400220195 Date Established 09-1&2001 REGISTER OF WI�LS Account Balance $ 13,522.39 1 COURTHOUSE SGlUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $6,761.20 Tax Rate X 0.045 Potential Tax Due $304.25 NOTE*: If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') 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 tax is 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 othe�boxes and disregard the amounf shown above as Potential Tax Due. g �The informatian is The a�ave�nformatiar�s correct, no deductions are being taken,and payrnent 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. n 4.5% I am a lineal beneficiary (parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at `�� right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on ihe 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 oiher boxes. Please sign and date the back of the form when finished. PART 2 Debts and Deductions 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 S 1/2"x 11"sheets of paper.) Date Paid Payee Description Rmount Paid Total (Enter on Line 5 of Tax Caiculation $ PART Tax Calculation 3 if ou are makin a correction to the establishment date Line 1 account balance Line 2 or Y 9 ( ) ( ), 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 decedenYs 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: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ �" , ._ . . 5. Debts and Deductions 5 - � 6. Amount Taxable 6 $ �� 7. Tax Rate 7 X 8. Tax Due 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 compfete to the best of my knowledge and belief. Work �... Home T ayer Signature Telephone Number Date �o�S! 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 , BUR�AU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � �� {�ennS�/LVBt'lld � PO BOX 280601 DEPARTMENT OF REVENUE HARRISBURG PA ��ZB-o6o� Information Notice REV-1543 E%DocEXEC (06-12) And Taxpayer Response FILE NO.21 i 4-0057 `' ACN 14106958 R��QRDED �FFtCE OF �ATE o2-�o-2o�a _ �� 4�ILLS p ii1 Type of Account �D�� A?a` �� `� � � Estate of EDWARD F HARRY Savings G�-�� QF Da e of De th06302-2014 T ustking JESSICA S WEN6ER ORPNANS' ��(��T County CUMBERLAND X Certificate 224 KEY WEST BLVD �±�' �� A.' �� CARLISLE PA 17015-8'�+� PNC BANK NA 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. Remit Payment and Forms to: Account No.31500219307 Date Established 09-18-2001 REGISTER OF WILLS Account Balance $6,608.38 1 COURTHOUSE SC2UARE CARLISIE PA 17013 Percent Taxable X 50 Amount Subject to Tax $3,304.19 Tax Rate X 0.045 Potential Tax Due $148.69 NOTE*: If tax payments are made within three months of the decedenYs date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. � A �No tax is due. 1 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 �The information is The above intormation is correct, no cseductiors 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. �4.5% I am a lineal beneficiary (parent,child,grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none}. p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete 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 2 Debts and Deductions Aliowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficienf to pay the deductibie items. B. You paid the debts after the death of the decedent�nd 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 � It 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 tvc 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: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 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, atong 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. Work Home ayer Signature Telephone Number Date .��i�� 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 '� � �-��, � t � �.�i! � � 1} � � Y .. ;., 'w'�" , d^ ....., �� ._ � : �-. ,._, �J r �' > T-� � J �:�' �', � X � �. ,�,• s..-i- �� _� � � J � � � � � : � �:; � � �a �: � 1 ' � u� �� .� � � � r ,� �-t � � - � � � � � � ... , � J �� : 4 � J � y '� � �' � � � �t� � � �� , � � � }� : � � / U � (y v c�', •t� �...s t'�• ;3 t � vd ''43 C��J��1��81�i1� ' � .i2�t10� .SP��{d�0 `� .�C ;;{��i� ,; ; v ,� x '� � ° ��' �� Z� Z W� hI �� htOl � N Q ^�' Y. y� � � i / [ C�. , •N w .4 S�i�}r� �i? '��s',S1�32� �, � � 30 3�1��0 �3��Q�3� : .