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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
~AXPAYE~ RESPONSE
FILE
ACN
DATE
NO. 21 05 30..4
05112972
03-17-2005
REV-15~S EX AFP U9-DGl
,Ii~'l':.!l/f DOROTHY Q SNYDER
S.S. tfO. 171-28-5611
DATE OF DEATH 12-18-2004
,COUNTY CUMBERLAND
TYPE OF ACCOUNT
IX] SAVINGS
o CHECKING
o TRUST
o CERTIF.
RONALD C SNYDER
73 FOXANNA DR
CARLISLE PA 17013
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
"ID PENN BANK has providBd thB Departmant with tha information listed below which has been USBd in
calculating the potential tax dUB. 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 Com.onwealth
of Pennsylvania. Questions May be answared by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 3037478
. . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Date
Established
07-28-1978
To insure propBr credit to your account, two
(2) copies of this notice must accompany your
paYMent to the Register of Wills. Make check
payable to: "Register of Wills, Agent".
1,170.97
50.000
585.49
.045
26.35
TAXPAYER RESPONSE
[!]liii!i!I~~~.~i!i!~i!ii!lll'i!i!I~~~!i!i!..~!i!i!~I!ii!~1!!il.~~I~~~!i!i!~U!i!!i~~.IIf1iii!iM.I!!!!~li!iill]~~!i!il!~~.il
A. ~ The above information and tax due is correct.
JP'1. You may 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 return this notice to thB RegIster of
Wills and an official assessment will be issued by the PA Depart.ent of RevenuB.
Accouni Balance
Percent Taxable
Amount Subject to
Tax Rate
Poieniial Tax Due
x
x
NOTE: If tax payments are made within three
(3) months of the decedent"s date of death,
yoU .By deduct a 5% discount of the tax dua.
Any inheritance tax due will become delinquent
nine (9) months after the date of death.
Tax
[CHECK ]
ONE
BLOCK
ONLY
B. 0 The above asset has been or will be reported and tax paid with the Pennsylvania Inheritanca Tax return
to be filed by the decedent.s representative.
C. 0 The above infor.ation is incorrect and/or debts and deductions were paid by you.
You Must cO/lplete PART 0 and/or PART @] below.
If you indicate a different iax rate} please siate your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
lINE 1_ Date Established
2. Accouni Balance
3. Percent Taxable
4. Anouni Subject to Tax
s. Debts and Deduciions
6. Anount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line S of Tax Conputation)
perjury} I declare that the facts I
my kno ledge and belief.
I
$
have reporied'above are irue} correci
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TELEPHONE
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ATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on inforllation
subllitted by the financial institution.
Z. Inheritance tax becomes delinquent nine .onths after the decedent's date of death.
3. A joint account is taxable eYen though the decedent.s neme was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint na~es within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly batHesn husband and wife lIore 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 tha information and computation in the notice are correct and deductions are not being claimed, place an "xn
in block "A"' of Part 1 of the "Taxpayer Response" section. Sign two copies and submit the. with your check for the BIIount of
tax to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official asseSSMent
(Form REV-1S48 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 fly the decedent's rspr-essntative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Depart.ent of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect andlor deductions are being clailled, check block "C" and complete Parts Z and 3
Bccording 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. Tha PA Department of Revenue will issue an official asses~ant (For_ REY-lS48 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART
z
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the account originallY was established or titled ih the _anner existing at date of death.
For a decedent dying after 12/12/82: Accounts which the decedent put in joint na_es within one (I) 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 numer 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 frog 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 1s 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
EXa.ple~ A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURYIVING JOINT OWNERS
in the namg of the decedent and two other ~ersons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100
16.77. (TAXABLE FOR EACH SURVIVOR)
B. The perc::ent taxable for assets created Kithin one ySar 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 IDD
PERCENT TAXABLE
EXaMplel Joint account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) = .50
in the naMe of the decedent and two other parsons and established within one year of death by
X 100
507. (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 4) is deterMined by multiplYing the account balance (line l) by the percent taxable (line 3).
S. Enter the total of the debts and deductions listed in Part 3.
6. The emount taxable (line 6) is determined by subtracting the debts and deductions (!Jna S) froll the BJlount subject to tax (line 4).
7. Enter the appropriate tax rate (line 7) as determined below.
D&t.e of Deat.h Spouse Lineal Sibling Collateral
07/01/94 to 12/31/94 37. 67- 157- 15%
01/01/95 to 06/30/00 OZ 6Z 15Z 15Z
07101100 to present OZ 4.5%_ 12Z 15Z
MThe tax rate I_posed on the not value Df transfers from a deceased child twenty-one years of age Dr y
ounger at
death to or for the use of a natural parent, <!In adoptive parent, or a stl;lpparent of the child is oX.
The lineal class of heirs includes grandparents, parents, children, and 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 descendants
and step-descendents. "Siblingsq Bre defined as individuals who have at least one parent in comMon with the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
A. You legally are responsible for paYMent, 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 payMent.
c. Debts being clabed .ust be itemized fully in Part 3. If additional space is needed, use plaln paper 8 112" x 11". Proof of
payment may be requested by the PA Department 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
SNYDER RONDAlD C
73 FOXANNA DR
CARLISLE, PA 17013
nnnn fold
ESTATE INFORMATION: SSN: 171-28-5611
FILE NUMBER: 2105-0303
DECEDENT NAME: SNYDER DOROTHY Q
DATE OF PAYMENT: 03/31/2005
POSTMARK DATE: 03/30/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 12/18/2004
NO. CD 005141
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05112972 I $26.35
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 419
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$26.35
GLENDA FARNER STRASBAUGH
REGISTER OF WillS