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HomeMy WebLinkAbout12-10-14 (2) COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020012 BUTLER JEFFREY J 317 RAVEN COURT MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold __________ -------- 14161068 $363.92 ESTATE INFORMATION: FILE NUMBER: 2114-0988 DECEDENT NAME: BUTLER ORA P DATE OF PAYMENT: 12/10/2014 POSTMARK DATE: 12/09/2014 COUNTY: CUMBERLAND DATE OF DEATH: 10/12/2014 TOTAL AMOUNT PAID: $363.92 REMARKS: M&T BANK CHECK# 200457233 INITIALS: WZ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax 4pennsyLVanla PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE -- "' REV-1543 EX Doc EXEC (08-12) Aliffn er Response FILE NO.2114-0988 ED OFFICE OF ACN 68 'REMSTER OF WILLS DATE 416102014 2019 GEC 10 �3M 1199 Type of Account C L Kith(o¢f ORA P BUTLER Savings © Ae� t� 109Chec 12-2014 T ustking ** JEFFREY J BUTLER EUM8ERLCoujnyCauM� � LAND Certificate 317 RAVEN CT MECHANICSBURG PA 17050-2001 M & T BANK 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. 15004232280153 Remit Payment and Forms to: Date Established 03-31-2014 REGISTER OF WILLS Account Balance $7,032.75 1 COURTHOUSE SQUARE Percent Taxable X 100 CARLISLE PA 17013 Amount Subject to Tax $7,032.75 Tax Rate X 0.045 Potential Tax Due $ 0.045 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 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 XThe information is The above information is correci, 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 F�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 F—] 12% 1 am a sibling of the deceased. 3 on reverse.) ❑ 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 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 .-----� Allowable debts and deductions must meet both nfthe-fol lowing thteha: A. The decedent was legally responsible for payment,o6dthe estate isinsufficient Vopay the deductible items. B. You paid the debts after the death ofthe decedent and can furnish proof o/payment if requested bythe department. (If additional space imrequired,you may attach 81/2^x11^sheets ofpapar.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) , $ PART Tax Calculation �--�—� |fyou are making mcorrection to the establishment date account balance(Line 2).orpercent taxable(Line 2), 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 ofthe account that iataxable toyou. a. First,determine the percentage owned bythe decedent. i. Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii. For established more than one year prior to the date of death,the percentage taxable is 1 bO%divided bythe total number ofowners including the decedent. (For example:2owners~50%.3owners=33.33%,4owners =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 ofany debts and deductions claimed from Part 2. G. 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. to If indicating a different tax rate, please state fUse�.0,\ - 0 AAF your relationship to the decedent: �A Department e 1 Date Established 1 111 4"1 2. Account Balance 2 $ Al "T 61 dil 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 4,164\,F,� iv Awm� Step 2: Sign and date bo|mw. Return TWO completed andsigned copies to the Register of Wills listed on the front ofthis form, along with acheck for any paymentyou are making. Checks must bemade payable 1n"Register ofWills,Agont" Dnnot send payment directly 0mthe Department ofRevenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the bestofmyknowledge and belief. &a4l-L Work 9#�Vg � Home -7 1 '-1 5-79 Tax -ayer Signafure Telephone Number Date �n � h p m r C h? _jK) v - -' Y�; N w y,. �. ry T�.