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Home My WebLink About12-03-14 BUREAU oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � enns Lvania Po BOX z8o6o� y P Y HARRISBURG PA 17128-0601 ICIfOrCTIatIO11 NOtIC@ DEPARTMENT OF REVENUE REV-1543B EX DocEXEL (OB-12) And Taxpayer Response FILE NO.2114-0807 ACN 14508355 DATE 11-25-2014 Type of Account Estate of CHRISTINE J MARTIN Security X SEC Acct Date of Death 08-03-2014 Stock PAMELA C MARTIN County CUMBERLAND Bonds 112 4TH ST BOILING SPRINGS PA 17007-9797 c7 `-��' � Q � � �TI try � �7 � �3 � � h � �_� � — --a-=. ;_" � r i --.� c7 ' ta u� .`.a rrr . � � -'^p FIDELITY INVESTMENTS provided the department with the information below indic�ti g �at a�he�ea��i of the above-named decedent you were a joint owner or beneficiary of the accounf�d trfied. �� --. Remit Payment and Forms to:;_:�, � � � o Account No.0 � D a t e E s t a b l i s h e d R E G I S T E R O F W I L L S Account Balance $84,368.54 1 COURTHOUSE SGIUARE Percent Taxable X 100 CARLISLE PA 17013 Amount Subject to Tax $84,368.54 Tax Rate X 0.045 Potential Tax Due $3,796.58 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. 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. 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 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), � - - pizase obtain a written correction from the financiai institution and attacn it to ihis Torm. 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 indicatin a different tax rate lease state ; �"��`� � ,��" ,� � g �p � �� ,�� o� your relationship to the decedent: ��`��\�\\\�, , � `' `�� ° " ��\\\,��\�\�� `��O��'� �� \��\ ��\\\ �\.� �� \ ��\\\\ \. \�� \ \ \�\\� \\\\\\\\��\�\ ��\ \\\\�\\� 1. Date Established 1 y�� ,��\\�\\��\��\��\\\\\��\\�� \��\\��\��\�\��\\\\\�\��\��\��\�.� 2. Account Balance 2 $ ��\��`\\\��\�\��\��\�\\��\\�\`��`� �\� �� \ �� \� 3. Percent Taxable 3 X �� - �� o�� AA��AA��V��AA VA�� A�AA��A�\ ��tiV� �.��VA�� \��A�A��A��A�� 4. Al1lOUilt SUbfOCt t0 T2X 4 � ��A`� �\y�� A� ��A � ��V� ��` ��' �V��V�� V`\�A�� A\\VA�� AV��V\\\\��A�� .rJ. �P.bt$811C) �BC�UCtIOII$ �J �� ' �V��,��\��A�A��A\A�A�VA�`�V��A��\�� \\V�� o�� ` \ �A oA�A�� A A � � m� ��ti� 6. ARIOUfIt T3X8b�@ 6 $ ��V�:�\VA �� \V`.�v\��A�v �AAA�A� � �� ; ��A �� o��\\o��o�� o��A �� X �\�� 7. �1X RatE.' � �� V�� V �AAAy��A�� . ��A��A �AA�� V�AVAV� ��A\AAAAOA�VAV� \�� .,..�� . � � \ :� �� '� 8. Tax Due 8 $ �\\��A\\�\��\�\`\ \�`�;��\\��\\��`� �\��`�oo°�O" �\��\��\\�� \��\� �� \; .9. Wlt�l.�J% �I$COUfIt �T�1X X .9�J� 9 X ��\��o��.��:��A\��.A��Ao��o�oa�.��.,a..... A ��:...a ��\��\.�:.: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 � �- — � ! d v 3 �� 3� � Taxpayer Signature Telephone Number Da e 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 Law Offices of SAIDIS, SULLIVAN & ROGERS A PROFESSIONAL CORPORATION 635 NORTH 12TH STREET,SUITE 400 CARLISLE OFFICE: ROBEP.T C.SAIDIS LEMOYNE,PENNSYLVANIA 17043 26 WEST HIGH STREET DANIEL L.SULL(VAN TELEPHONE: (717)612-5800-FACSIMILIE(717)612-5805 CARLISLE,PA 17013 ELYSE E.ROGERS EMAIL:attorney��ssr-attorne, s.y com TELEPHONE:(717)243-6222 JOHN A.FEICHTEL www.ssr-attorne, s.y com FACSIMILE:(717)243-6486 MAPYLOU MATAS AN1�'A BORRO HAYS Of Coi�nsel UEAN E.REYNOSA STEPHEN L.GROSE TODD F.TRUNTZ SEAN M.SHULTZ REPLY TO LEMOYNE xANNax wHITE-cissoN December 2, 2014 717-901-7781 crule@ssr-attornevs.com Re�ister of Wills of Cumberland County One Courthouse Square Carlisle, PA 17013 Re: Estate of Christine J. Martin File No: 2014-00807 Dear Madam: Enclosed is a Pennsylvania lnheritance Tax Information Notice and Taxpayer Response for the above-referenced estate. Please note that the account in question will be reported on Mrs. Martin's inheritance tax return. If you have any questions or require additional information, please do not hesitate to contact me. Sincerely yours, � r Cy hia J. Rule Legal Assistant to Elyse E. Rogers cj r Enclosure cc: Pamela C. Martin (w/enclosure) � � � rn -� o rr� �., �"� � � � rn � � � rn � � � � w � � � ,�.� . �,:"�l � � .. f'"v ...� � � � � � . . F�7 � � � � � � � ,�„� `.^+� . � s r-- rn -.� -� r Y7' �� \.L� � � � � � � � �" �.: o z �. 0 � � `� � � y � � � � � � � � � � o � � � � � ,-� � c* J " UO � � � � �• � CD rA U O ,.... t::�. C: J � _�:� � � c� 3 i i �, (D � ; �•. � C/� ;i '_' O C�D E..(i � � � � `� �-h � O O c°1D � .� T� � � O� ��x' � ;�� .; � � �_ �� cD � � +.�. � r�—• �I S� _ � — �- O � _ ,� � � �"�� "@�• r �, �� ffi N�. ��c� . -. � �� ».. �' �� "� ��,`� �;��.� <,`