HomeMy WebLinkAbout12-04-14 (4) BUREAU OF INDIVIDUAL TAXES PO BOX 280601 Pennsylvania Inheritance Tax pennsyLvania
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
REV-15438 EX D..EXEC(08-12)
And Taxpayer Response
FILE NO.2114-0755
ACN 14508024
DATE 11-12-2014
Type of Account
Estate of KERMIT W HOLLER
Security
SSN X SEC Acct
Date of Death 07-18-2014 Stock
JENNIFER R MANLOVE County CUMBERLAND Bonds
208 S 16TH ST C=
CAMP HILL PA 17011-5507 C) rn
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WELLS FARGO ADVISORS 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.5509 Remit Payment and Forms to:
Date Established REGISTER OF WILLS
Account Balance $6,710.40 1 COURTHOUSE SQUARE
Percent Taxable X 25 CARLISLE PA 17013
Amount Subject to Tax $ 1,677.60
Tax Rate X 0.150 NOTE*: If tax payments are made within three months of the
Potential Tax Due $251.64 decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) 1(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.
A F-]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.
B F71 The information is The above information is correct; node7dbEli6ris arell-5dihg taken,"JNd 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. F-1 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part F-] 12% 1 am a sibling of the deceased.
3 on reverse.)
F-] 15% All other relationships(including none).
D 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
L_AJ
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.
i ,
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 t 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 "intrust 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 �� �flICta�se my AAF °j
your relationship to the decedent: �� bey ��
ake �\ PA Department ofevenue
1. Date Established 1 � \ G
2. Account Balance 2 $ \\ \` \\ \\\\ \
3. Percent Taxable 3 X
2 ;
4. Amount Subject to Tax 4 $ 3US
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MR,
5. Debts and Deductions 5 -
6. Amount Taxable 6 $ `
7. Tax Rate 7 X a
8. Tax Due 8 $ �
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a 2
9. With 5% Discount(Tax x .95) 9 X �� �,�; .\"�-,_.�.—: �_��
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 J
Home /7" 761- t-733
-733
xpayernature 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
BANCS LAW OMCE, LLC
429 SOUTH 1ST"STREET PHONE: 717-730-7310
CAMP HILL,PA 17011 FAX: 717-730-7374
E-mail: mikebangs(a)verizon.net
MICHAEL L.BANGS,Attorney-at-Law WILLIAM E.MILLER,JR.
WENDY K.STRAUB,Paralegal Of Counsel
December 2, 2014
Lisa-M. Grayson, Register of Wills
Cumberlarid.County Courthouse
. .L
iic: .C,.ru.th
ouse Square
Carlisle, PA 17013 -
RE.; Estate of Kermit W. Holler
File No. 21-14-0755
Dear,Ms.,.G.rayson:
Enclosed you will find four (4) PA Inheritance Tax Information Notice and Taxpayer Response
that I file as part of:the above-referenced estate on behalf of Lara Messer, Christopher Manlove,
Jennifer Man ove and.Steven Schaffer.
Thank you.
Very truly yours,
Michael L. Bangs
Enclosures
cc: Mr. Michael.A. Hornsby