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Home My WebLink About11-04-14 BUREAU OF IN�IVIDUAL TAXES Penns Ivania lnheritance Tax �� DennSY Lvania PO BOX 280601 Y • + HARRISBURG PA 17128-0601 IC1fOCCT1at1011 NOtIC@ ° DEPARTMENT OF REVENUE ---��r REV-1543 EX UocEXEC (OB-12) And Taxpayer Response FILE NO.21 -�l�- 7{� �, ACN 14142352 DATE 07-28-2014 Type of Account Estate of ARLENE F GREGORY Savings Checking Date of Death 07-13-2014 Trust ZACHERY A DAILEY County CUMBERLAND Certificate 2121 DOUGLAS DR CARLISLE PA 17013-1024 C7 ,� � �� Q � � :�~�j � �--'' !j hl i� :.'� ;^, ,�`��. �� C�i . j -J : �,,.,� �t,� • , �' -1 `�` MEMBERS isr Fcu provided the department with the information below indicat'r�g that at i� d�l��f the above-named decedent you were a joint owner or beneficiary of the account identified. f..., �� r��r � Remit Payment and Forms to: �'� Account No.462305 Date Established 05-18-2012 REGISTER OF WILLS Account Balance $330.95 1 COURTHOUSE S(�UARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $165.48 Tax Rate X 0.150 Potential Tax Due $24.g2 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. I 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. 3 �The�nfarmation i� The abcve in'or�ati�r �s:,orrect, rc deducticns«rz��ng,a�er�, and payrr�e��t wifl be se��t 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 � �2% 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. F Please si n and date the back of the form when finished. � 9 � 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. �� ' y � �v�' � :\��\ �� If indicatin a different tax rate, lease state ��,��`��; � � � ��\�\�� 9 P � �� `��,��v��'�� \�\��\��\ your relationship to the decedent: , ,� ,\\� \�� \��\\�� ,�� ' �\\\\� \� 1 `�� j\�\��\ y��;��\��\\\��\�;�\� 1. Date Established `��\\�\�.:`��`\\\\��\��\\\\��\��\��`\\�\\�`\\� �\�\ \��\ �\�\ �\\ \\\ 2. Account Balance 2 � � ��\\\\\�\�\�\\\`��\��\��o�\�\��\��\��\��\��\�� \�\ . � �� \\��\�\\\ 3. Percent Taxable 3 X �'��`��` � �� y�\\�� A �� \V��VV��V�A\��\�VA��A�V��\�� A� A��V�� A� � ��\��A�A��V��V�\�� 4. A1710Uf1t SUL��BCt t0 T1X 4 $ ��A�� `� `�` ` A � `A ` `�� Ao�� ` � �a��o��\\��\��\��\�A��A��\\V`�V�o��A�\�\�\\V�� J. �@btS 311C� �@C�UCtIOfI$ 5 ��\\�\��v�� \V `�� A\�V � �� A��\ ` ��A\�V��A��\\��A��\��\V ��: �� A�\ � �� \\V ��\\�� \�A�� 6. Amount Taxable 6 $ "��\\��°`��\�\��\\��\��\\��\\��\��`��y �� \ \�.:�y�� \��\��`��\��`�� \� 7. Tax Rate 7 X �� \\\�� \�0��\�\�\��\\�� \\��\��\ �� \��\ �\\��\\��\�\��\��\\��\�\\�\\�., ��\ \ �� \\�� 8. i ax t�u e lS � ��`'\�\��°��\\�� \�\\\`��\\\��\��S �\ ��\`\\\ ��\\ ��\\��\��\ �\\\\��\\\\�\��\\��. 9. With 5% Discount(Tax x .95) 9 X a�\\�\�\�\��a�.\\\\��\��aa�\��\\`\\\��\\a\��\��\�\\\\�\�a��v\\��.:��\ 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 /U � Taxpayer Sign 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 B�R�o oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � Del'11'1Sv Lvania PO BOX 28D601 Y r J HARRISBURG PA 17128-0601 IC1fOCI71atIOC1 NOtICe ' DEPARTMENT OF REVENUE And Taxpayer Response ' RE°-'S`3B E'°°`EXE` `°B-'Z' FILE NO.2114-0700 ACN 14507393 DATE 10-17-2014 Type of Account Estate of ARLENE F GREGORY Security X SEC Acct Date of Death 07-13-2014 � , Stock KIMBERLY M NOON County CUMBERLAND � onds 27 CARAVAN CT � q � MIDDLETOWN PA 17057-2810 � � � t'.� 3 � �14 ;=� c'� ��. �-�.� ";f5 :.� . r- C:� , --C r;-� �� i �.a r .. �7 � C.�) � :' C`� - �, �- �r -c � c� � ARIS CORPORATION 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.676 Remit Payment and Forms to: Date Established REGISTER OF WILLS Account Balance $310,796.46 1 COURTHOUSE S(�UARE Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $51,800.45 Tax Rate X 0.045 Potential Tax Due $2,331.02 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 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 u i ne information is ' The above infiormation is correct, no deductions are being taken,and payment wili be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �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. 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 inheritance tax form Return filed by the estate representative. REV-1500. Proceed fo 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), piease obtain a written correciion from the fiinanciai insi[ilution and ai�ach it to this ferrm. 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: ��` �� 1. Date Established 1 2. Account Balance 2 $ � � 3. Percent Taxable 3 X 4. Amount SubjeCt to Tax 4 $ �-.� � ��•'��, � ��" ��`��\a\�� '�' � �\ \ \ 5. Debts and Deductions 5 - � � � \" 6. Amount Taxable 6 $ �� 7. Tax Rate 7 X � 8. Tax Due 8 $ ��;,�z��..�, °,��.�.�.. :�\\�, \�. ; � ..•:�� .��r��: � 9. With 5% Discount(Tax x .95) 9 X � �� \ ��so�� s� �� '� 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 _�.��(.��,9�.� � .�y� Home /d�cZ^�/'Y Taxpayer Signature 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 � ��r�� : � � Q � � � � � S=� � � � � � U°I � � � � ., c � � m . o rn � . � � � � �� _ C � .'.� - ._ . ...a :'� r- � � �y r' �.''.� �.> .;, � � _ �•.t °::� ,-. �, -n ,:� ' i�� , � -� � ,r F:�. � `„ ' :.. �,-� �;�? � c.� -- r,t i�;; --� r-- t,„i � �.�. � F--' L''� p f b i �\r.� 14Ji �� , � \ . � � 8� � � � � 1�+. � �_ t� - � �. ��-J! � _ � �; � � U � -� � �,,; �� , �.: �: .� -> �; � i ::�t �y 4 ;. ��' �5< �. 'i ��. � " " � a � �. �, ,;, <;, t � : `� :- �,,,: j� - � �� , : ��