HomeMy WebLinkAbout08-11-14 (2) BUREAU oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � pennS�/LVa1118
PO BOX 280601 � �
[^,[� � ;J �I t1011 NOtIC@ DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0601 �,r,� '
r5��� ; ; An�'����C ayer Response REV4543 EX DocEXEL �oa-�2�
i,�,� i, , ._._,� FILE NO.2114-0465
REVISED NOTICE ACN 14141444
* * * * * * DATE 08-05-2014
.!; ,�t v
Type of Account
QI���iu�l�,� 'vVuK; Estate of MARY M GABRIEL Savings
CUM�ERLAND C0, PA Da e o6Death 05107-2014 X T ustking
ALAN J 6ABRIEL County CUMBERLAND Certificate
1350 CARRIAGE HOUSE RD
MIDDLETOWN PA 17057-5963
PNC BANK NA 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.
Remit Payment and Forms to:
Account No.9200493832
Date Established 09-27-1984 REGISTER OF WILLS
Account Balance $7,396.73 1 COURTHOUSE SGIUARE
Percent Taxable X 16.667
CARLISLE PA 17013
Amount Subject to Tax $ 1,232.g�
Tax Rate X 0.045
Potential Tax Due $55.48 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% 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 tax is 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 Potentia!Tax Due.
g �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% 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 reverse.)
� 15% All other relationships (including 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 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
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.
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.
If indicating a different tax rate, please state ���s�`' � V � ' �� � �� � �\
your relationship to the decedent: ` '` � , ��� \
1. Date Established 1 � �
\� �� �
2. Account Balance 2 $ �� `' � �
3. Percent Taxable 3 X ����� � � � � ����
_�� .����`�� �� � � �.. '�
4. Amount Subject to�Tax 4 $ � � �
5. Debts and Deductions 5 - � � � �� � �� \\
6. Amount Taxable 6 � ��� �� � � �� ��� � ��� ���
��\����,.�,,\\ .�\. \. � �� . �
7. Tax Rate 7 X � �� �\�\ � .� � � � '�
�� ��� \ �__ �,
8. Tax Due 8 $ ` ` '�� � � � �
� �\ � �. � ����� �
9. With 5%Discount(Tax x .95) 9 X ,���������.��'���������� ������� ��a\��A�����\\�� �\�\\� �
Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wilis 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
1 :.������_l� Home 717 - 3 (v 4 - n S y F� d� �f
Taxpayer Sig f ture 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
BUREAU OF INDIVIDUAL TAXES Penns\,Ivania lnheritance Tax �� � � Per11'1S�/�Vd111c�
PO BOX 280601 !
HARRISBUR6 PA 17128-0601 � f I�torr�-r��`i�m OtIC2 �' DEPARTMENT OF REVENUE
'"'��4�id��-axpaV�, � 1�esponse RE�-1543 EX DocEXEG (08-12)
�.V�,, , .. '',�, :� FILE NO.2114-0465
REVISED NOTICE ACN 14141446
* * ,. * * *
DATE 08-05-2014
�n 3 t,,{11 � �S� .
Type of Account
���;N��,��� �����tate of MARY M GABRIEL Savings
Cu�1�$�R�p
05-07-2014 Trust
ALAN J GABRIEL CountyCUMBERLAND Certificate
1350 CARRIAGE HOUSE RD
MIDDLETOWN PA 17057-5963
PNC BANK Na 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.
Remit Payment and Forms to:
Account No.9285034802
Date Established 01-26-1983 REGISTER OF WILLS
Account Balance $15,928.58 1 COURTHOUSE S�UARE
Percent Taxable X 16.667
CARLISLE PA 17013
Amount Subject to Tax $2,654.82
Tax Rate X 0.045
Potential Tax Due $ 11 g,47 NOTE*: If tax payments are made within three months of the
decedenYs 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 tax is due. I am the spouse of the deceased or 1 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 Potentia/Tax Due.
g �The information is The above information is correct, no deductions are heing 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 reverse.)
� 15% All other relationships (including 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 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
5'�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.
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 decedenYs 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.
If indicating a different tax rate, please state \�� �` � � ` � � � ` \�
,\
your relationship to the decedent: � �� ' V �
1. Date Established 1 ���
�. \�\
2. Account Balance 2 $
3. Percent Taxable 3 X � � �,�" �� � - �� � ,� ��. .
4. Amount Sub ect to Tax 4 $ � �� �� �� � � �
� ,� ��,�, . �.. �\���� '..., \ \ \\\
5. Debts and Deductions 5 -
�� � � ��
� � � .� � � . �
6. Amount Taxable 6 $ � ���� ��=� � �� ���� � � ���-�
.A. � ���\ � . �.
7. Tax Rate 7 X �� ��� . .
8. Tax Due 8 $ a���\�\�. � �\����� ..��. �\\ . �
� , _
�� '�A� �� .
���j���� .\� ��\\ „_��
9. With 5% Discount(Tax x .95) 9 X �\\� �� "�\�������������\� ''� \���\\�v���o� � \�
Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wilis 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 � 7 � 3 t�n y ` 7� 3 �� � � �
Taxpayer Sig ture 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
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