HomeMy WebLinkAbout06-17-14 PORE OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax pennsylvania
HARRISBURG PA 17128-0681 InfOrmaYlOn NOYICe DEPARTMENT OF REVENUE
"`° 13 1 80 (08-12)
And Taxpayer Response
FILE NO.2113-1280
ACN 14123658
DATE 05-07-2014
Type of Account
Estate of MARY C THOMAS Savings
SSN 160-36-3464 Checking
Date of Death 09-11-2013 Trust
TODD L WHITNEY County CUMBERLAND Certificate
115 BIG SPRING TER
NEWVILLE PA 17241-9111
METRO BANK 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.537043077 Remit Payment and Forms to:
Date Established 06-17-2005 REGISTER OF WILLS
Account Balance $3,290.08 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $ 1,645.04
Tax Rate X 0.150
Potential Tax Due $246.76 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. r ;
a
A ❑No tax is due. I am the spouse of the deceased or I am the parent of a decedent wl
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the ai u,
shown above as Potential Tax Due. O "
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. B The infona p
tion is The above information is correct, no deductions are being taken, and payment will be se! (�Sj.]' UO
correct. with my response. !, o O
Proceed to Step 2 on reverse. Do not check any other boxes.
O
C The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent,child, grandchild, etc.)of the decease( O 0 .—� O
(Select correct tax rate at U O
right, and complete Part ❑ 12% 1 am a sibling of the deceased. I� � U
3 on reverse.) U
❑ 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.
E F71Asset 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.
� 1
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 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 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.
indicating a different tax rate,please state Official Use Only ❑AA
your relationship to the decedent: PA Department of Revenue
1. Date Established 1
2. Account Balance 2 $ PAD
3. Percent Taxable 3 X 1
2
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 $ r
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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Taxp er ignature 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
J 1505610105
REV-1500 EX(w,')(FB
PA Department of Revenue PannsyttvaMa OFFICIAL USE ONLY
Bureau of Individual Taxes ""` . County Code Year File Number
PO BOX 28o6o1 INHERITANCE TAX RETURN yp
Harrisburg,PA 17128-0601 RESIDENT DECEDENT L9 J'J �oL 0 L
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
160-36-3464 09111/2013 04/23/1944
Decedent's Last Name Suffix Decedent's First Name MI
Thomas Mary C
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number "
' THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CID 1.Original Return C=D 2.Supplemental Return C'1 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4.Limited Estate C= 4a.Future Interest Compromise(date of 5. Federal Estate Tax Return Required
death after 12-12-82)
X C-D 6.Decedent Died Testate O 7.Decedent Maintained a Living Trust _., 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.) .
C= 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death CM 11. Election to Tax under Sac.9113(A)
Between 12-31-91 and 1.1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime LCgVepflone Numi&R :O
x a ;;0 M
Kimberly A Hawkins g 0 � rrI c->
CO -n — o
R S' WILLS USE ON+YC1
D = M CPI :73 C>
First Line of Address z O C>
a n n -n -Y7
164 Faith Circle n ^
Second Line of Address = :;a
j P- Cn C>
CD
City or Post Office State ZIP Coda DATE FILED
Carlisle Pa 17013
Correspondent's e-mail address:
Under penalties of perjury.I declare that I have examined this return.Including accompan'ymg schedules and statements,and to the best of my knowledge and belief,
11 Is true,correct and complete.Declaration of preparer other than the personal represanietive is based an all infonnatlon of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY -
Side 1
1505610105 1505610105 J
1505610205
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name: Mary C Thomas 160-36-3464
RECAPITULATION
1. Real Estate(Schedule A). ............................................ 1. 0.00
2. Stocks and Bonds(Schedule B) ....................................... 2. 0.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3. 0.00
4. Mortgages and Notes Receivable(Schedule D)........................... 4. 0.00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 0.00
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 6,395.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) m Separate Billing Requested........ 7.
8. Total Gross Assets(total Lines 1 through 7)............................. 8. 6,395.00
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 7,374.00
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............... 10. 335.00
11. Total Deductions(total Lines 9 and 10)................................. 11. _ 7,709.00
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 0.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) .............. ......... 13. 0.00
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 0.00
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rate X.0_ 16.
17. Amount of Line 14 taxable - - -at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateralrate X.15 18.
19. TAX DUE ......................................................... 19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
L 1505610205 1505610205 J
pennsylvania SCHEDULE F
DEPA R TMENT OF REVENUE
TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
'tINHERITANCE
ATE OF:ry C Thomas _ FILE NUMBER:
If an asset became jointly.owned within one year of the decedeTJt's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS
RELATIONSHIP TO DECEDENT
A.Carl Thomas 115 Big Springs Terrace
187-52-0139 Newville, Pa 17241 son
B.Todd L Whitney 115 Big Spring.Terrace
177-54-2377 - Newville, Pa 17241 none
C
i
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY
IFEN FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S DATE OF
VALUE OF
NUMBER TENANT MINT IDENFIRTNG NUMBER.ATTACH DEED MR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
'
I. A. 0724/06 Mobile Home-212FDR60B900
9,500.00 50 4,750.00
2 B 01/01/05 CheckingAccount4MetrobankAW#537043077 3,290.00 50 1,645.00
TOTAL(Also enter on Line 6, Recapitulation) $ 6,395.00
If more space is needed,use additional sheets of paper of the same size.
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