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Home My WebLink About11-07-14 BUREAU INDIVIDUAL TAXES 28 PO BOX 280601 Pennsylvania Inheritance Tax a pennsyLvania HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REV-1543 EX D-EXEC (08-12) And Taxpayer'Response FILE NO.2114-0894 ACN 14159825 RECORD [? OFFICE of _ DATE 11-03-2014 2014 NOU 7 PType of Account Estate of HELEN SHICORA Savings C L E R ; X Checking ORPHANS' C( r, Date of Death 09-15-2014 Trust STEPHEN A SHICORA _T County CUMBERLAND Certificate 400 WOODLAND AVE CUM8ERLt;,!D NEW CUMBERLAND PA 17070-1818 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. Account No.5000771588 Remit Payment and Forms to: - Date Established 09-22-1999 REGISTER OF WILLS Account Balance $2,320.12 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $1,160.06 Tax Rate X 0.150 Potential Tax Due NOTE*: If tax payments are made within three months of the $ 174.01 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. B 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. F-] 4.5% 1 am a lineal beneficiary(parent, child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) 15%' All other relationships (including none). D F-]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. t 1 Please sign and date the back of the form when finished. V? I i PART r 2 Debts and Deductions Allowable debts and deductions must meet both of the following criteria: I 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 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 Official Use Only ❑AAF your relationship to the decedent: PA Department of Revenue 1. Date Established 1 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 1 2 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 6. Amount Taxable 6 $ 5 7. Tax Rate 7 X 6 8. Tax Due 8 $ 7 8 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. ` s Work -71-2-- Home 71-?Home Taxpayer Signature Telephone Number Date 1/1//& 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 t, -.��.. � �..��.-...� lt.. 1. " s:f� � � A .r...�_ -. ... .... _vr.�.,,.._• r OS ICES OF . s17 & SHEKLETSKI _ ``` •••� E STREET x.06 Nov 8:.' ` "s .� 'M�PiTNEY BOWES ,E BOX E PM-4 L 02 IP $ 000.690 .ND, PA:17070 0001828600 Nov as 2014 _ MAILED FROM ZIP CODE 17070 'Cumberland Count; Register of Wills 1 (f6urt:house Square Room 102 Cr±-lisle, Ftp 1.7,013 . t t ,i .+ .•«.w.w �:r - ' 1' "" ,#f,, � STONE LAFAVER & SHEKLETSKI ATTORNEYS AT LAW 414 BRIDGE STREET DAVID H.STONE POST OFFICE BOX.E OF COUNSEL GERALD J.SHEKLETSKI NEw CUMBERLAND,PA 17070 CHARLES H.STONE www.stonelaw.net . JON F.LAFAVER ' TELEPHONE(717)774-7435 FACSIMILE (717)774-3869 November 6, 2014 Cumberland County Register of Wills 1 Courthouse Square Room 102 _ Carlisle, PA 17013 RE: Estate of Helen Shicora Estate•No: 21-14-0894 Greetings: We represent the Estate of Helen Shicora. Please find attached three (3) original Pennsylvania Inheritance Tax Information Notice and Taxpayer Response for the following ACN No.: 50000771588. .. o"', Please time-stamp one 6f the`iriginals .and return it to us in the enclosed self-addressed, stamped envelope wehave-provided for your convenience. Thank you .-for your:attent on^Min this matter. Please do not hesitate to contact us should you have any questions regarding this matter. Very truly yours, STONE LaFAVER& SHEKLETSKI Gerald J. Shekletski, Esquire GJS/ Enclosures C':1 o r; . cc: Stephen A. Shicora, Administrator r c� o .,fin . ,s tJ —( N r-- rn Cn CD Co -►�.