HomeMy WebLinkAbout11-18-14 BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 Y Penns Ivania Inheritance Tax k'. pennsytvanla
HARRISBURG PA 17128-0601 Information NoticeDEPARTMENT OF REVENUE
REV-1543 EX UocE%EC (OB-12)
RECORDED FAcgaxpayer Response FILE NO.21 __
REGISTI±R d ILLS ACN 14160998
DATE 11-10-2014
2014 gu 18 rim 11 Ul
Type of Account
G LE C F Estate of BERNECE J WACKER Savings
ORPHANS COURT Checking
Hj`N, lc ?�, Date of Death 10-13-2014 Trust
THOMAS R WACKER �'� � County CUMBERLAND X Certificate
617 W SHADY LN
ENOLA PA 17025-2054
MEMBERS 1ST FCU 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.386475 Remit Payment and Forms to:
Date Established 06-29-2013 REGISTER OF WILLS
Account Balance $2,694.79 1 COURTHOUSE SQUARE
Percent Taxable X 16.667 CARLISLE PA 17013
Amount Subject to Tax $449.14
Tax Rate X 0.045
NOTE': If tax payments are made within three months of the
Potential Tax Due
$20.21 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 0 The tax rate is incorrect. ❑ 4.5% 1 am a lineal beneficiary (parent,child,grandchild,etc.) of the deceased.
(Select correct tax rate at
right, and complete Part F-1 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 IV Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
L�N 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 ofthe following criteria:
/
A. The decedent was legally responsible for payment,and the estate isinsufficient Vopay the deductible items.
B. You paid the debts after the death cfthe decedent and can furnish proof rfpayment ifrequested bythe department.
(If additional space iorequired,you may attach 81/2^x11''sheets ufpopar.}
Date Paid Payee Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) , $
PART
Tax Calculation
' .`wu,Aremakinq a curreomon,u».x*=establishment date account ba>onoe(Line2),mrpercent taxable(Line.3)'
please obtain a written correction from the financial institution and attach it tmthis 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 atthe date ofdeath.
3. Enter the percentage of the account that iutaxable Vmyou.
u. First,determine the percentage owned bythe decedent.
i. Accounts that are held"intrust for"another nrothers were 1O0%owned bythe decedent.
|i. For established more than one year prior tothe date nfdeath,the percentagetaxable iu1UO%divided
bythe total number ofowners including the decedent. (For example:2owners=5D%.3owners=33.33%.4owners .
=25%.e0cj
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.
S. 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.
If indicating a different tax rate,please state Official Use Only [I AAF
your relationship to the decedent: PA Department of Revenue
2. Account Balance 2 $ PAD
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 - 4
Step 2: Sign and date below, Return TWO completed andsigned copies to the Register ofWills|inhad onthe front ofthis form,
along with acheck for any paymentyou are making. Checks must bemade payable to"Register cfWills,Agan1.^ Donot send
payment directly Vothe Department ofRevenue.
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,C
Home
Taxpayer Signature Telephone Number Date