HomeMy WebLinkAbout06-05-14 (3) SUREAU OF"INDIVIDUAU TAXES Pennsylvania Inheritance Tax pennsytvania
PO BOX 280601 Information Notice ] DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0601
RC_O__( i(t �} spp nse ear.�sasa a ascscc,ra-,x>
P4tt FILE NO.2114-0257
REGISTER OF kIILL$�t ACN14502801
DATE 05.07-2014
Z015 5 Rn 11 41
Type of Account
CLERK OF Estate of MARIE M MANSFIELD Security
ORPHANS' CO(J"Iffi3'?S�N�� �SECAcct Stock
STEVEN R MANSFIELD CUMBERLAND CO.cd%tyCUMBERLAND14 Bonds
604 E SIMPSON ST '
MECHANICSBURG PA 17055-3455
! SAN`rANDER SECURITIES 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.7417410148313 Remit Payment and Forms to:
Date Established REGISTER OF WILLS
Account Balance $12,368.66 1 COURTHOUSE SQUARE
Percent Taxable X 5 CARLISLE PA 17013
Amount Subject to Tax $6,194.43
Tax Rate X 0.045 NOTE': if tax payments
Potential Tax Due $278.30 e f dah are made within three months n 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. 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.
3 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. 4.5°l4 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% 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 Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA inheritance Tax
nheritance 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.