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INHERITANCE TAX
RECORD ADJUSTMENT Pennsylvania
BUREAU OF INDIVIDUAL TAXES
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 09-17-2014
ESTATE OF SIPE LOIS J
DATE OF DEATH 07-28-2013
FILE NUMBER 21 13-0840
COUNTY CUMBERLAND
VIRGINIA M GARDNER SSN/DC 3140ACN 13150168
1303 BRANDT AVE Amount Remitted
NEW CUMBERLAND PA 17070-1534
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS E—
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REV-1604 EX AFP (12-13)
* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 09-17-2014
ESTATE OF: SIPE LOIS J DATE OF DEATH: 07-28-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0840 S.S/D.C. NO. : ACN: 13150168
ADJUSTMENT BASED O,N: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: METRO BANK ACCOUNT NO. : 102609
TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING C ) TRUST ( X) TIME CERTIFICATE
DATE ESTABLISHED 10-08-2008
Account Balance •00 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax •00 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount •00 AT THE ADDRESS SHOWN,--ABOVE.
Tax Rate X .045 MAKE CHECK g MONEY §#DEIt;,-1PWYABLE
Tax Due 00 TO: "REGISTERF WIL , C "
TAX CREDITS : �,� � cn )
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID -;3
- Tri co
C.
4--" In
A C,J
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A
"CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
PAYMENT: Detach the top portion of this notice and submit with your payment made payable to the name and address
printed on the reverse side.
Make check or money order payable to: REGISTER OF WILLS, AGENT.
Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the
appropriate county, or the issuance of an Orphan's Court citation.
REFUND (CR): A refund of a tax credit, which was not requested on the tax return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available from
the Department's web site, www.revenue.state.pa.us, any Register of Wills or Revenue District Office, or from
the Department's 24-hour answering service: 1-800-362-2050; services for taxpayers with special hearing and/or
speaking needs: 1-800-447-3020 (TT only).
REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, PO Box 280601, Harrisburg, PA 17128-0601, or call
(717) 787-6505.
DISCOUNT: If any tax due is paid within three calendar months after the decedent's death, a five percent discount
of the tax paid is allowed.
PENALTY: The 15 percent tax amnesty non-participation penalty is computed on the total of the tax and interest assess!d,
and not paid before Jan. 18, 1996, (the first day after the end of the tax amnesty period.)
INTEREST: Interest is charged beginning with first day of delinquency.or nine months and one day from the date of
death to the date of payment. Taxes which became delinquent before Jan. 1, 1982 bear, interest at the rate of
six percent per annum calculated at a daily rate of 0.000164. All taxes which became delinquent on and after
Jan, 1, 1982 will bear interest at a rate which will vary from year to year with the rate announced by the
PA Department of Revenue. Rates for 1982 through 1999 can be found in the Pennsylvania Resident. Instruction
Booklet, (REV-1501) the Pennsylvania Non-resident Instruction Booklet (REV-1736) or on the Pennsylvania
Deptartment of Revenue Web site www.reyenue.state.pa.us. The applicable interest rates for 2000 through
2014 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
2000 8% .000219 2001 97 .000247 2002 6% .000164
2003 5% .000137 2004 4% .000110 2005 5% .000137
2006 7Y. .000192 2007 8% .000219 2008 7% .000192
2009 5% .000137 2010 4% .000110 2011-2014 3% .000082
Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days
beyond the date of the assessment. If payment is made after the interest computation date shownon the
notice, additional interest must be calculated.
REV-1470 EX(01.10)
- 2113-0840
1
pennsylvaniaINHERITANCE TAX
DEPARTMENT OF REVENUE 07/28/2013
EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG. 7 -06
DECEDENT'S NAME
Lois J Sipe 2113-0840
REVIEWED BY ACN
Robin /Agent 191 13150168
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
A review has been conducted on this account. The Department has determined that this
joint bank account will be properly reported on the probate return. Therefore, this
assessment has been corrected.
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