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HomeMy WebLinkAbout04-11-05 COMMONWEALTH UF PENNSVLVANIA OEPA~TMENT OF REVENUE BUREAU OF :::iUiVIDUAL TAXES llEPT .:-Z8'D60l HARRISBURG, PA 17128-0601 . INFORMATION NOTICE ""~" AND TAXPAYER RESPONSE FILE ACN DATE NO. 2105 '():l)"-1 05109838 03-10-2005 REV.1545 EXAfP tDg.OD> i "E~ OF JANE DAVIS 5.5. NO. 211-32-3603 DATE OF DEATH 11-20-2004 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS IX] CHECKING D TRUST D CERTIF. PETER T ADAMS 129 W GREENHOUSE RD DILLSBURG PA ,.\5 pJ- [>7/ I 17019 ,- Dr T*'\ t p,1. ~ , n~ REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a COpy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COMMonwealth of PennsYlvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . S~~ REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 197362-11 Oat. 09-29-2000 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due 6,146.28 50.000 3,073.14 .045 138.29 x Tax x To insure proper 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". NOTE: If tax pay~ents are made within three (3) .onths of the decedent's date of death, you may deduct a 5~ discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) months after the date of death. ./ PART TAXPAYER RESPONSE [!].~~.iili~lii!il_I!I!I~~~I!I!!I.~~!I!I!~II!I!.i!!!II~1~.!lili~~~I!I!II...1!!I.I!I!III~I!I!.~~!I!i.~1i11 A. D The above information and tax due is correct. 1. You Nay 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 may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY 8. 0 The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax return to be filed by the decedent"s representative. c. D The above inforllation is incorrect and/or debts and deductions were paid by you. You must complete PART 0 and/or PART ~ below. If you indicate 8 different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Dl!lte Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT,TRUST ACCOUNTS I. 2 3 4 5 6 7 8 x x DEBTS AND DEDUCTIONS CLAIMED PART [!] DATE PAID AMOUNT PAID t J )~ DESCRIPTION L-/~II IhJ 4~4~' TDTAL (Enter on Line 5 of Tax COMPutation) I $ PAYEE perjury, I declare that the facts I my knowledge and belief. if Under penalties of ~e to tha best of T;6~K~E ' haY. reported HOME (7' "7 WORK f:7/7 TELEPHONE above are true, correct and ) 43::>"~ 9.L3/ ) ~cF-, )~ NUMBER as- 4- ,3- DATE GENERAL INFORMATION '\ 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on infornlation submitted by the financial institution. 2. InheritancB tax becomes delinquent nine months after tha decedent.s date of death. 3. A joint account is taxable even though the decadent's name was added as a matter of convenience. 4. Accounts (including those held between husband Rnd wife) which the decedent put in joint na.as within one year prior to death are fully taxable as transfers. 5. Accounts established jointlY between husband and wife .ore than one year prior to death are not taxable. 6. Accounts held by a decadent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 TAXPAYER RESPONSE 1. BLOCK A - If the infor.ation and computation in the notice are correct and deductions are not being clai.ed~ place an "X" in block "A" of Part 1 of the "Taxpayer Responsen section. Sign two copies end submit the. with your check for the a.ount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assess.ent (For. REV-1548 EX) upon receipt of the return fro. the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative~ place an "Xn in block nB" of Part 1 of the "Taxpayer Responsen section. Sign one copy and return to the PA Department 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 and/or deductions are being claimed~ check block "Cn and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit the. with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return fro~ the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However~ there is an exclusion not to exceed $3~OOO per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (~~) appears before your first n~e in the address portion of this notice~ the $3~OOO exclusion already has been deducted from 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 is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Example: A joint asset registered DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 16.7X (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent"s death or accounts awned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS DR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 X 100 soX (TAXABLE FOR EACH SURVIVOR) 4. The a.ount subject to tax (line 4) is detenmined by multiplying the account balance (line 2) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Dat. of Death Spouse Line.l Sibling Collateral 07101/94 to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% 15% 15% 07101/00 to present 0% 4.5%_ v 12% 15% ~The tax rate imposed on the not value D' transfers from a deceased chIld twenty-one years of age or yo unger at death to or for the use of a natural parent~ an adoptive parent~ or a stepparent 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-descendants. nSiblings" are defined as individuals who have at least one parent in com.on with the decedent~ whether by blood or adoption. The nCollateral" class of heirs includes all other beneficiaries. CLAIMED DEOUCTIONS PART 3 DEBTS ANO DEDUCTIONS CLAIMED Allowable debts and deductions are deterMined as follows: A. You legally are responsible for payment~ or the estate subject to administration 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 claimed must be itemized fully in Part 3. If additional space is needed~ use plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Depa~t.ent of Revenue. -::J2 L. ~ '''r ,./ " .. ~,. .' ~~':,-.:l.Ad".,t:fi ~ J # '" 4Jf1,,," .,if W' : t' , ," _.1 / 0' , ". ./ ~LL23/or " </o"p,~ ! / /.!i;:;;; Ie ,; ---t-'-GiiT"'" , .. , / 'I L' i I / (,) l ti' < 'J'J, ~l, C/ -'X>;' t!. t!.LW:t..tJ..~1 . ,"'1" '1. J ( , I' :: ':?~t'(",:Ct,..., I:~' l L::! _ ____:: .IJ'$~.2 c JYY} P-,?9-.&!^" rd, "/i'a,rJA::"';...2'P ,~;:? f^:,:"ZJl?e.~_..,* ~-/ r{/. "'. ... r', . ,f.,! ')!:' ;. ,~~~'" ~t/,,:J,LL,r,.'l l ?-t)""'jl.t.(.,,,,-,c1 f ,'Jf:!. C-'.d71J/>I/>''''''' ') cf- ,;1' . j, ().5? /~ -L[f.l/e .$0--,7 , .C) I' /::<5- 00 ;:: / o-ft.--<" '\. <; 1 .......; ~-,. . ~ II.... ('; .s. ~.\ ~';'~'''~;i";; ~~. ( "" 9, 1" I .b.t.,J'l.LA.L.~;;;;' t! (~.L""/" ('(~<.,,-,~/.v,'~i/~~._.--Z-~:Z~.ES: ! ~J,;'Q tot' '7 7 ._l~ ..L. ~ )/~ /" I ..1 :l/1~/",;~'/ UIIJ+~ ~ LL-I~ "'>J-I!.f -( 7-.1 .~ -'< C.a::~"',,,^, ~ <i ...L--- ..__.~-- .0 ...., '" J. w..-.......L-L[(..d1, "J~.. Ck-..;i ...... .__'" . P 1 ft...,....., :..!l........L~ f!.J../\N-, D _ . .JUJtJJI ) ("4:;~/2A~~,,~,_:-~L___ I Q(), 0<:,;: J~ '3,<0 fj __~~L;'~ i .~)-? .5" d",_!:LQ 3.5". Ca "~ ".J'.,~eI C. L.",. ~"'i " " . iJ .. ( r:<,.H.~ ~~- ') (, '( CdA~'; ~"-.6 ') J J....<L. .ft'D 1f.1!.... Cf "L $'50. () C) .". ~ t'.j. ;I ..>1. . t r'-'t.. ) f ~~ A ,,,,",'.-t.'."7' i ,-':'~ ,-' (' 1'3 Cl-~.Q~"\..",". .t? (".1\.<1.>. ..... Cf'1ITS5 - f I -- ~ ~=~~--t-=-~~ II: -.--.-..----+i-i-------.-.-- II -. ......---.........-.---.-.-....-. -------~-__---r..i I'~.I ~--.---------~--~-_._---- -'-.-.._____.______.._ ~----~-_._--,_.._._--_.._---,----,--~--~-- ii' Jl ~..---_._,..-.-.._._-------:' :--~-------_.~._-~---_.--_.. .----.-.- --_.-.- . -' '--_._.--~-------- --- - ----- ---------~- - ----~..._---~._._--._..- . COMMO~ oAlT~ nF PENNSYLVANIA DEPA~. ~NT DF REVENUE BUREA~ OF ,INDIVIDUAL TAXES DF.:PT. 2806D1 HARRISBURG, PA 17128-06D1 * INFORMATION NOTICE AND TAXpAYER RESPONSE FILE ACN DATE NO. 21 0''> ()~S7 05109839 03-10-2005 REV_1545EXt.FPtB9_00l TYPE OF ACCOUNT IX] SAVINGS o CHECKING o TRUST o CERTIF. TO: RD PA 17019 E&T. OF JANE DAVIS . "I S.1i. NO. 211-32-3603 DATE OF DEATH 11-20-2004 COUNTY CUMBERLAND REHIT PAYHENT ANO REGISTER OF WILLS CUMBERLAND CO COURT CARLISLE, PA 17013 FORHS PETER T ADAMS 129 W GREENHOUSE DIL LSBURG HOUSE I1EI1BERS 1ST FCU has provided the Department with the inforllation listBd below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you f8el this infor.ation is incorrect, please obtain written correction from the financial institution, attach 8 COpy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Questions lIay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 197362-00 Oat. 09-29-2000 Established PART [!J 2,793.14 50.000 1,396.57 .045 62.85 TAXPAYER RESPONSE i!!!!II~~~.i!ll.iiii._ii!I~I~~~ii!II..~!i!i!~II!i!~lii!!.~~~~~!!li!.!I!lll~~II!ill~~lil!!~i!il.~~ilil!.~.i!!I! To insure proper credit to your account, two (2) copies of this notice .ust acco.pany your pay~ent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x x NOTE: If tax payments are ~ade within three (3) months of the decedent"s date of death, you .ay deduct a SZ discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. c=J The above infor.ation and tax due is correct. 1. You lIIay choose to rellit paYllent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. B. c=J The above asset has been or will be reported and tax paid with the PennSYlvania Inheritance Tax return to be filed by the decedent"s representative. C. 0 The above information is incorrect and/or debts and deductions were paid by you. You must complete PART 0 and/or PART ~ below. x If you indicate a different tax rat., please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION l.tNE 1. D:ete Established 2. Account Balance 3. Percent Taxable ~. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x PART [!] DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED f ( :) rkl!:: DESCRIPTION LA 51 T r-+7T /-J "-li~?) TOTAL (Enter on line 5 of Tex Computation) AMOUNT PAID I $ perjury, I declare that the facts I my knowledge and belief. have reported above are true, correct HOME ("'7/" ) ..f'3.J..- 1.2.3/ WORK (7/7 ) ~- 6"dY-.J..)P,' TELEPHO E N ER end \)- 4'-3-OS- DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on inforll8tion submitted by the financial institution. Z. Inheritance tax beca.es delinquent nine months after the decadent"s date of death. 3. A joint account is taxable Bven though the decedent's na.B was added as a mattar of convenience. 4. Accounts (including thOSB held between husband and wife) which the dBcedsnt put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife .ora than one year prior to death are not taxable. 6. AccQunts held by a decedent "in trust for" another or others arB taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the infer.atlon and computation in the notice are correct and deductions are not being Claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the a~ount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Texes, Dept 280601, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being Claimed, check block "C" and complete Parts 2 and 3 according to the instructIons below. Sign two copies and submit them with your check for the amount of tax payable to tha Register of wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of wills. TAX RETURN PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. Howevar, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the nUMber of accounts held. If a double asterisk (..) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted fro. 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 is determined as follows: A. The percent taxable for joint assets established .ore than one year prior to the decedent"s death: 1 DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Example: A joint asset registered DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS> = .167 X 100 16.7X (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year 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 100 PERCENT TAXABLE Example: Joint account registered the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 in the name of the decedent and two other persons and established within one year of death by X 100 50X (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is deter.ined by multiplying the account balance (line 2> by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) fro. the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Date of De.th Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3X 6X 15X 15X 01/01/95 to 06/30/00 OX 6X 15X 15X 07/01/00 to present OX 4.5%- 12X 15X .. I he tax rats 1Mposed on the not value of transfers from a decsa sed Chlld twenty-one years of age 0' y ounger at death to or for the use of a natural parent, an adoptive parent, or a stepparent 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-descsndants. "Siblings" are defined as individuals who havs at least one parent in co.mon with the decedent, whsthsr by blood or adoption. Ths "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 administration 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 claieed IlUst be itemized fully in Part 3. If additional space is needed, use plain paper 8 112" x n". Proof of payment may be requested by the PA Dspartment of Revenue. _y.:t~, ..~ ""}" ,.,-,~~b .; ,.,. (.J( ~ / ,l~ ,~ 1/! ''''',' L' ()i V' ., .,' ""-" ......~.... "" / / $' j, t.1~ J.; ._-~ :;.18f.:,?' - I / _lfl.1___1h-'f / I ' -Lp:l " .S' , , I I ,., / I .!t , IJ" .'--~ , I I. "/1;' .~_!J '(" r:} , , __L;J:.l_j~L/ , J ~ "l -J:;.: __'~ W -1. i 11:l5/Qu - / / , ".- / ~ n JJ ""/ .;- . -7--:' '/ '~jn 1;)... (. "t~ 0--1'-. "- (,;;<,.~ O/^".. i--.)._________ _L ':l /I<~. " 11 (j.U)~t. 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