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HomeMy WebLinkAbout06-05-14 (4) BOREAU 28 INDIVIDUAL TAXES Pennsylvania Inheritance Tax enns lvania PO BOX 280601 y ./ HARRISBURG PA 17128-0601 Informaloh-Notice DEPARTMENT OF REVENUE RECD?- � 'do cy rpesponse FILE NO.2114-0257 REGISTER OF WILLS ACN14119412 DATE 04.14-2014 2019 JUN 5 Fill 1191 Type of Account t L E f"K OF Estate of MARIE M MANSFIELD Savings 0RPHANS' COURT SSN Checking Date CUMBERLfCUMBERLAND14 Trust AND CL1,P&unt Certificate SHARON M BAR$ARETTA t y 4201 GETTYSBURG RD CAMP HILL PA 17011-6670 WELLS FARGO 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.$814185693 Remit Payment and Forms to: Date Established 04-24-2012 REGISTER OF WILLS Account Balance $3,406.48 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 1,703.24 Tax Rate X 0.150 Potential Tax Due $255.49 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 q/a 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 E]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. S F_ITheinformation 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% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part F_� 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. l( Please sign and date the back of the form when finished.