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HomeMy WebLinkAbout05-07-14 1 COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-9f! DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.260601 HARRISBURG,PA 17128 0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 019125 RAYMUNDO ROXANNED 1145 BEREA DRIVE BOULDER, CO 80305-6637 ACN ASSESSMENT AMOUNT CONTROL NUMBER ---------- ------- 14118734 ( $12.50 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-1271 DECEDENT NAME: RAYMUNDO RODOLFO G DATE OF PAYMENT: 05/07/2014 POSTMARK DATE: 05(02(2014 i COUNTY: CUMBERLAND DATE OF DEATH: 09/11/2013 TOTAL AMOUNT PAID: $12.50 REMARKS: CHECK#452 INITIALS: DB1 SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax - ax Wl,��UD..MC �WM ennsylvania Fla BOX 286601 EPARTMENT OF REVENUE HARRISBURG PA 17128-0661 Information Notice And Taxpayer Response FtLE N0.2113-11 271 ACN 14118734 DATE 04-08.2014 Type of Account Estate of RODOLFO G RAYMUNDO Savings SSN Checking Date of Death 09-11-2013 Trust ROXANNE RAYMUNDO County CUMBERLAND X Certificate 1208 WELL DR CAMP HILL PA 17011-1231 0 C> m on 4 { ITT 70 r m M n o � ::E c7 0 -n n PSECU provided the department with the information below indicating that at the deaih i�5 the ro r,-- m above-named decedent you were a joint owner or beneficiary of the account identified -4 Account No.19i460366 Remit Payment and Forms to: Date Established 10-23-2006 REGISTER OF WILLS Account Balance $1,666.62 1 COURTHOUSE SQUARE Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $277.78 Tax Rate X 0.045 NOTE`: If tax payments are made within three months of the Potential Tax Due $12.50 decedent's date of death,deduct a 5 percent discount on the tax With 5°Iu Discount(Tax x 0.95)—$(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 AE]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 other boxes and disregard the amount shown above as Potential Tax Due. - B FThe information is The above information is correct, 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 F-]The tax rate is incorrect. Z4.50% I 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% All 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. EE]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-15oo. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. ,in' 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 8 112"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"intrust 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 1000%divided by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners =25 0%, 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 a different tax rate,please state 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 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X B 8. Tax Due 8 $ 8 9. With 5% Discount(Tax x .95) 9 X z 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, t declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work _ Home Taxpayer 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 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. C© 019123 RAYMUNDO ROXANNE D 1145 BEREA DRIVE BOULDER, CO 80305-6637 ACN ASSESSMENT AMOUNT CONTROL NUMBER 14118732 $50.87 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-1271 f DECEDENT NAME: RAYMUNDO RODOLFO G DATE OF PAYMENT: 05/07/2014 POSTMARK DATE: 05/02/2014 COUNTY: CUMBERLAND DATE OF DEATH: 09/11/2013 f TOTAL AMOUNT PAID: $50.87 REMARKS: CHECK# 454 INITIALS: D61 SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIOUAr TAXES Pennsylvania inheritance Tax Pennsylvania PO BOX 280601 t! DEPARTMENT OF REVENUE HARRISBURG PA 17128.0601 Information Notice a , NEV-1545 EX DOGFU[ 105-17) And Taxpayer Response FILE NO.2113-1271 ACN 14118732 DATE 04-08-2014 Type of Account Estate of RODOLFO G RAYMUNDO Savings SSN Checking Date of Death 09-11-2013 Trust ROXANNE RAYMUNDO County CUMBERLAND X Certificate 1208 WELL DR CAMP MILL PA 17011-1231 ry a ,p C> 73 Ski c m n 70 ' ca M -V t,, �c f11 x --t � � C� �o o C) 1 c3 ra r—r— rn PSECU provided the department with the information below indicating that at the math of th5 above-named decedent you were a joint owner or beneficiary of the account identified. Account No.191460366 Remit Payment and Forms to: Date Established 09.06-2005 REGISTER OF WILLS Account Balance $6,781.95 1 COURTHOUSE SQUARE Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $1,130.35 Tax Rate X 0.045 Potential Tax Due $50.87 NOTE*: If tax payments are made within three months 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 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 Tex Due. B The information is The above information is correct, 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. d4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part 012% 1 am a sibling of the deceased. 3 on reverse.) 0 15% Ali 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 8112"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 y g { ) }, 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"intrust for"another or others were 100%owned by the decedent. fl. 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 a different tax rate,please state 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 1 4. Amount Subject to Tax 4 $ 3 1 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 { 7. Tax Rate 7 X 8 8. Tax Due 8 $ 7 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. Work Home q" 310g0S I' Taxpayer 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 ANDIOR SPEAKING NEEDS ONLY: 1-800-447-3020 COMMONWEALTH OF PENNSYLVANIA REV-7162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT Na. ca 019124 RAYMUNDO ROXANNE D 1145 BEREA DRIVE BOULDER, CO 80305-6637 ACN ASSESSMENT AMOUNT CONTROL NUMBER 14118730 i $49.20 ESTATE INFORMATION: SSN: , FILE NUMBER: 2113-1271 DECEDENT NAME: RAYMUNDO RODOLFO G DATE OF PAYMENT: 05/07/2014 4 POSTMARK DATE: 0510212014 COUNTY: CUMBERLAND DATE OF DEATH: 09/11/2013 TOTAL AMOUNT PAID: $49.20 REMARKS: CHECK# 453 INITIALS: DB1 SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax Pennsylvania PO BOX 280601 � alit DEPARTMENT OF REVENUE HARRISBURG PA 17128-0601 Information Notice And Taxpayer Response F 15 o,=ExES<qa.,z, FILE NO.2113-1271 ACN 14118730 DATE 04-08-2014 Type of Account Estate of RODOLFO G RAYMUNDO Savings SSN Checking Date of Death 09-11-2013 Trust ROXANNE RAYMUNDO County CUMBERLAND Certificate 1208 WELL DR - CAMP HILL PA 17011-1231 Yl'7 ro o :Z c rn c o m c-� 3: ::a coo Mo n c cn s ram r-,*�3 g Ln C> 7 cO CD N r- M r- -o PSECU provided the department with the information below indicating that at the dead of the cr1 above-named decedent you were a joint owner or beneficiary of the account identified. Account No.191460366 Remit Payment and Forms to: Date Established 01-15-1977 REGISTER OF WILLS Account Balance $6,560.23 1 COURTHOUSE SQUARE Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $1,093.39 Tax Rate X 0.045 Potential Tax Due $49.20 NOTE*: payments are made within three months 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 1 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 Ta;:Due. - B he information is The above information is correct,no deductions are being taken,and payment will be sent correct. with my response. Proceed to Stop 2 on reverse. Do not check any other boxes. C ❑The tax rate is incorrect. d4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part 012% 1 am a sibling of the deceased. 3 on reverse.) ❑ 15% All other relationships(including none). D F�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-15oo. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. �Q{ U t 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 6112"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 4 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 a different tax rate,please state Official Use Only 0 AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 j 2. Account Balance 2 $ PAD 3. Percent Taxable 3 x 1 j 2 1 4. Amount Subject to Tax 4 $ 3 J 5. Debts and Deductions 5 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 x 6 6. Tax Due 8 $ 7 $ . 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. Work < � ��� Home Taxpayer 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 \ � > � , ¥ 2 \rn / . » ƒ C3 r\) 77 . $ % L \ . to = > < -% • � . ` � A . 7 � Q . , . iz, �y