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Home My WebLink About06-27-14 _ " _ _ _ _ � � , , BUREAU oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � ennS ��vania PO BOX 280601 � Y P Y , HARRISBURG PA 17128-0601 IIIfOCf�T�'at1011 NOtIC@ :� DEPARTMENT OF REVENUE And Taxpayer Response RE�-'S"EX°°` E``°°-'Z> ± FILE NO.21 —�� ACN 13134071 ' � DATE 06-25-2013 i Type of Account ° Estate of HANNAH JACOBS Savings SSN 207-07-8443 X Checking Date of Death 10-27-2012 Trust JOEL R�; JACOBS County CUMBERLAND Certificate 2 LOCU�T HOLW CARLIS�E PA 17015-7429 � � � � s . � � � �a � �7 � � � r,.{�, � :? ...i;; C"', � �- c.,"S ._. - ' , r�p�� .-.�;3 .. � ,_ �-...... �„� F ..., . r"� � -...� . i .. f,...".. ...� .,. ,v i'-; 7 " . . -' ��7' , � `°:' �`_' �L7 , Ca c�� '.�,' `'°y � .,.:P „77 � �3 „� �' /`'l� �""'- �"7 �►, 3--� �7 '` 0 � � SOVEREIGN 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 Nof 21086338 Remit Payment and Forms to: Date Establ'rshed 08-07-2007 REGISTER OF WILLS Account Balance $3,032.01 1 COURTHOUSE S�UARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $1,516.01 Tax Rate X 0.150 ` Potential Tax Due $227.4p NOTE': Ii tax payments are made within three months of 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 St�p 1 : Please check the appropriate boxes below. y A 0 No ti�x is due. I am the spouse of the deceas��l o� I am the parent of a dec�dent who was � 21 years old or younger at d�te of death. ` � Proceed fo Step 2 on reverse. Do not check any other boxes and disregard the amounf shown above as Potenfial Tax Due' g u The information is The above i��formation is cor'rect, 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% I am a lineal beneficiary(parent, child, grandchild,etc.)of the deceased. , (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on r�verse.) � + � 15% All other relationships (iricluding none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed.' Comp/ete Part 2 and part 3 as appropriate on fhe back of this form. i E �Asset 4vill be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance;Tax inherit�nce tax form Return filed by the estate repfesentative. : REV-1500. Proceed fo Step 2 on reverse. Do�ot check any other boxes. � � ; Please sign and date the k�ack of the;form when finished. , � , r , ¢ 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 l��Z E� (L �'►^�c - � n[ V/�C�"A� !. d� ov r: l h�q3=s2 • 6� � 3' �.c �Ms A�n d R � o -�1-! 7S, 00 /- �o - 1 e...' d b • C a ' a o l• v 7 . �t Total (Enter on Line 5 of Tax Calculation) $ 2 Z� .Sr� 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. ,��o� � �� : � : � ��, �� .�� <.�. If indicating a different tax rate, please state ��y�� , �� \� � ��\�� \\� \��o�� \. ��.��` � � �� A �� \ your relationship to the decedent: O1f Q \�\��\� � ` ;\ � � 1. Date Established 1 g'- � ` .� � ��A�� A� �� \�� . ��, .�: � 2. Account Balance 2 $ �.�3Z .� 1 � �� 3. Percent Taxable 3 •.�Q � X �� . � � 4. Amount Sub'ect to Tax 4 $ [ �• 0� � �� s��a ��`V V``�� o��c��. �� ' �;A��; s� ��\\\\��\�� \��\�\��\� �� \�� 5. Debts and Deductions 5 - 2., Z��/.1�� y\\ �� A�� y�� ,,�, ��\� ,�\�� ::�� 6. Amount Taxable 6 $ (� �� s�� . T8X f�8t8 ] X C'/..7 �� a � A �\ �� Ir ��\\\�\\,��\� \�� c� ��\\\\ �� :`. .:\\\ ��'"� \\\�\��\� 8. Tax Due 8 $ O ��y,�� . � � .. . ��`�\��\�\ � �, . .� 9. With 5%Discount(Tax x .95) 9 X d ��\\\a��a��v��o �o�o��\��o � �e�� o' o��o��\�� 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 � ( 7 � Z `�'( -'3`�3� Taxp er Signatur Telephone Number Date � /d /3. 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 � pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP C12-13) HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS DATE 05-26-2014 �Fv?;�; :��; ';, , i'i`%� CF ESTATE OF JACOBS HANNAH .�;-�, - - �_1 j DATE OF DEATH 10-27- 012 `"° - � FILE NUMBER ��f�,rj�� COUNTY UMBERL��ID JOEL R JACOBS ��i� �� OSSN/DC ACN 13134071 2 LOCUST HOLW - �- APPEAL BY DATE:07-25-2014 (' , 't _ CA R L I S L E P A 17 015-7�+'� 9 ,.��-�- (See reverse side under Objections) aft�E� Amount Remitted ,��-.:� ,; �, �. P� Nont v C�::�.+��=`•'• - - • � MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 , .�:g , _:_:� i t �l,i ."� �� ,•� .,4 �:='�-I�� (} i -,.- } # � � , _ . ; ; ,.;, n � � Z01� Ji1�'U �? 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