The URL can be used to link to this page

Home My WebLink About12-22-14 BUREAU OF INDIVIDUAL TAXES Po BOX Zao6o� Pennsylvania lnheritance Tax � pE1111S�/LVd111a HARRISBURG PA 17128-0601 �nf�C�'1atIOr1 NOtIC@ ' DEPARTMENT OF REVENUE And Taxpayer Response "E"�'S°3 Ex°°°ExE< <oe-=z> FILE NO.2174-0317 ACN 14162829 DATE 11-24-2014 Type of Account Estate of OLGA DELPINO SSN 156-30-6086 Savings COURTNEY A LAWSON 2014 Checking 3825 CONESTOGA RD County CUMBERLAND X Trust CAMP H I L L PA 17011-1417 Certificate � BANK OF AMERICA NA provided the department with the information below indicatin�Fr�t at th �eat�ro' c o ...c ao rn the above-named decedent you were a joint owner or beneficiary of the account ide�fi r, � �;,�' Account No.68100451007459 Remit Payment and Forms to: r� � � N �`� +�n Date Established 10-05-2000 : r�r� -;�� N .:w;� ca Account Balance REGISTER OF WILLS �� "`` �a �� $24,693.09 1 COURTHOUSE SQUARE , � � � �'�� ..�� Percent Taxable X 33.333 CARLISLE PA 17013 F::a � ,-:,. __.. Amount Subject to Tax $8,230.95 '� �-' r- � Tax Rate X 0.150 �'•7 �� r � Potential Tax Due $ 1,234.64 NOTE*: If tax payments are made within three months of the With 5% Discount(Tax x 0.95) $(see NOTE*) decedenYs date of death,deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. PART gtep 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 27 years old or younger at date of death. Was Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potentia/Tax Due. B �"fhe 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 beneficiar (Select correct tax rate at Y(parent,child, grandchild, etc.) of the deceased. 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. Comp/ete 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 ' heritance tax form Return filed by the estate representative. EV-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 responsiof therde edent and can furn shlproof of payme naf req es edtbytheedepartment. B. You paid the debts after the death (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), please abta'sn a+r�ritten cosre�tion from the#in�r�cia!inst�t�.ition 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"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established ncl d na the decedent r(Fo he amplef 2 o ne se p50%n3 ownersbl 33.33°%/4 ownetls by the total number of owne 9 =25%,etc.) b. Next,divide the dec Xd s determined by mult plyb gtthe a count balance by the percen�ttaxalbleries. 4. The amount subject to ta 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 sub�ect to tax 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent \\\\\\\\ \\ �� \��qQ��\\\ x �^. \��p��\��\�� \�\��\��3��5v��i��p\\��\� If indicating a different tax rate,please state \��\��\\�\\\��\�\\\\ �� , �� \`�\��j,��. . �� C@C�Oflt: ��\\��\�\�\�°��o�� \\v��\��\��\\��\��\ your relationship to the de ��\��,�� \��\��\\�� \\�,��\��\�`\��\�� 1 � ��\\�� \\�\�\��\��\��\�\\\��\�\�\\��\\��\�\\�\�� 1. Date Established � � �\ ��, �,� � �� "�`�`�� \\\ o� �� \ \\�� \�\\\ ��\��\�� \\�� \�\\��\��\��\\\\��0��\��\a�\��p� 2 � ��\\��\��\� ��\��\�� 2. Account Balance ��\\o�\��\\��\�\\��\\\�\��\�� \��\`��. X �� . , `3 ��\�� \�� \��p��\�\�\�\��\\��\�\�o��\�� \�� 3. Percent Taxable �� , �� ` �� o�� `��.. 4 � a��\\ �\�\�\\�\\� �\��0�\��\\�� \�\\��\\��\\\��Q�\\\`\�\�� 4. Amount Subject to Tax �� "� �\\��p�� \� �\\�\�� \�\\\��\\�\\\�O\ \��\\��\�\�� \\`��\\��\��\\\\\��\��\��\�\\\��0��\�\��\��\\\�\��\\��\\��\�: 5. Debts and Deductions 5 - �� ° " , „� �� , `�� \��\�\`��\�\��\�\��\�\\�e\\�\�� \��\v�\\��\�\�� \��:�V�A�� .A� �V��V��A��\�A��V��VA�AA��. ��A AA�� 6, IQIllOUtlt TSX3b�8 6 � ��AAV �� A�A ��A ��A� �`��\ � ��A�\�A�V�VA��`\�V��\��AVA�AA�VA�A��V�VV�A VA�\� ,j X ��V\ �� ? T2x Rate �� v . r ��AA ��A��A\ ��A�`��\��A��Y��\�A 8 �j ��y��y�yy��v�y��y��vv��y��v��y��yv�� \\�V�AA`,AA�A�\VA �� 8. T3X DUe ` ��A��v�� oy�� ,� X ��C�� \� �\��,�..��\\..��vo��O.,...�\��....\�\\\�`.'.a��\O\\\��...��\�,�„:� .��o,\a�a\\\��.�\�\\a . .. g. With 5%Discount(Tax x .95) 9 Step,2: Sign and date below. Retur fTWO nom Che ks mus9be made payab e oegReg ste olflWillseAgent e Donnot sendorm, along with a check for any payment you a 9 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 l C� S ll « �� Taxpayer ignature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT pIV S ON LATN717-D7g7 g32MEN S RVICESEFOR DISTRICT O F F I C E, O R T H E I N H E R I T A N C E T A X TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONL Y: 1-8 0 0-4 4 7-3 0 2 0 BUREAU OF INDIVIDUAL TAXES Po BOX z8o6o� Pennsylvania lnheritance Tax � pC1111S�/(Van18 HARRISBURG PA 17128-0601 Information Notice j DEPAR EMENE OF REVENUE And Taxpayer Response FILE NO.2714-0317 ACN 14762830 • DATE 11-24-2014 Type of Account Estate of OLGA DELPINO SSN 156-30-6086 Savings BRADLEY C LAWSON 2014 Checking 3825 CONESTOGA RD County CUMBERLAND X Trust CAMP HILL PA 17011-1417 Certificate � r�y C� � � �� r� � � F� �-+� f"" �� V') �i �,,, yi.r iV �-�f c:� c/� `", �V �"� �,Y7 _. , �`�7 !'� r � C`) ��a f� � .) C:� ��! � -7.1 ` � � � � .,� � `� �-n G7 O BANK oF AMERICA NA provided the department with the information below indicating that at the de h of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.68100451007459 Remit Payment and Forms to: Date Established 10-05-2000 Account Balance REGISTER OF WILLS $24,693.09 1 COURTHOUSE SQUARE Percent Taxable X 33.333 CARLISLE PA 17013 Amount Subject to Tax $g,230.95 Tax Rate X 0.150 Potential Tax Due $ 1,234.64 NOTE*: If tax payments are made within three months of the With 5% Discount(Tax x 0.95) $(see NOTE') decedenYs date of death,deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the a p i ppro riate boxes below. A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who wa 21 years old or younger at date of death. S 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 �'`fhe tax rate is incorrect. � 4.5% I am a lineal beneficiar (Select correct tax rate at y(parent, child, grandchild, etc.)of the deceased. 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. Comp/ete Part 2 and part 3 as a ro r�ate on the back of this form. PP p � E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inh ' inheritance tax form Return filed by the estate representative. eritance Tax 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 respo�hlof therdecedent and can furn shlproof ofcpaymen�taf req es ed by theedepartment. B. You paid the debts after the dea (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 ou are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3)� Y - piease ubtai�a ws�itfe�ca�r2ction frors's tne fina��:�s�nstitution and attach�t to this orm. 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 establ�sne d n�lud ng the decedent r(For examplef 2 o ne se p50%n3 ownersbl 33.33°%/4 owneas by the total number of o =25%,etc.) b. Next,divide the de�a d s determined by multi y b gtthe account balance by the percen�t taxalbleries. 4. T h e a m o u n t s u b�e c t t o 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 sub�ect to tax 7. Enter the appropriate tax rate from Step 1 based on your relationship to the deced�� ,.` � ��o��\'\ �� \��\� �� \��\\� °, ,please state � �`"` � � �� ``�� ` �� If indicating a different tax rate ��,��`��\� ; """"`"�"` � �� " ��"�� ' - � � �� . �� \�\\ our relationship to the decedent: �T.=� �� ` "�"�� ` � `` � ` �� S�� \�`�� \\\\��\�\\\ \�\�\\��\\\�\\\��\ Y � , 7(7 O � �\��\��\� �\�\��\��\ \\�\\��\�\ � te Established 1 ��"�- �S- c — �� \\�,�\�� \��.� ��,�� \��\�� 1. Da t r � r, �� \��o�`��\�\�� \��\��\��\�\\��\ �7 ��\\�� \\�� \p\ \��\\��\�\\\��\��R�\\\\ 2 $ Z. ( 3 �\\ \� �� \� � \��\��\\\ ��\� 2. Account Balance 7 ��\\\��\\��\��\\�\��\�\\\\��\� � � �\ �.7 J )3 ��\o � .� �� p��\�� X ^ � ' ��\ � �� c � \�a\ � •3 � �� \�\\��\��\��\\\��\��\�\\�\\�\��\��\� 3. Percent Taxable ,�, , �� ` ��\ a $ �l 2 3� �t S � �,�, �� `��`�� 4. Amount Subject to Tax r, " �� " �`� - �J �� . � �� \�\\ �\\\\ � ��\��\\ �\\�\�\ � � ., ��y\\�� \�\\\��\\\\�\\��\�\� �J �� \��o��O��o`\`�\�\��\\\�`�\\��\\\�\��\�\�\� \ \\\�\�\�p��\�� 5. Debts and Deductions r1 � � �� „��,��;o�� W U ��Ci .�� \�\�\�\\��\��\��\�\��\��\\\��\��\��\�\\\\�\\� Ej � �� A�a ��A�VA �� O�\VAA ��O�V��A A AV�\�V��\ 6, AfT10Ullt TaX8bI6 � � �� `��V�� . � �� A �� A��V�p�VA�\AAAVAVA . � ��A'. 7 X V�� \ �� A��AA�� AAV�O�AoA pVAA� A�Y.�A ��O�oA�AAV�V ��.�. � AAA� � � ,A A� � : �� . ? TaX R3.� �� A*\,�V`��AA��\��\\��\�� s � 3 �� 3� �� , ,,, � � � \ � � �� \� 8. TcIX�U2 �A�� yo� v�A`�V� ��o��y A ��A�� X ....�\�,.\� >�\��\\,\\\\��\��.��\�� \��\a��\\�Oc:�.�\��:�a�\\\\�\\�.\�ti\�\\�@��\ g. With 5% Discount(Tax x .95) 9 Step,2: Sign and date below. Retur�nrTWO ng Che ks musgbe made payable oegRegiste ofIWillseAgent e Donnotfsend�rm, along with a check for any payment you 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 �O� ' ��.�4 Z� �,. � � "�_ Home � � ?- (�`1�`- �4� � �-�� I �f � Telephone Number Date Taxpayer Signature IF YOU NEED FURTHER ASSISTANCE, CONTAXT DIV S ON LATN A 7D 8P 832MEN S RVICESEFOR DISTRI C T O F F I C E, O R T H E I N H E R I T A N C E T TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ON L Y: 1-8 0 0-4 4 7-3 0 2 0 BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 280601 HARRISBURG PA 17128-0601 �nf�rmatl0C1 NOfIC@ DEPARTMENT OF REVENUE And Taxpayer Response RE�-1543 Ex°°=Ezec cosan FILE NO.2114-0317 ACN 14162832 DATE 11-24-2014 Type of Account Estate of OLGA DELPINO SSN 156-30-6086 Savings COURTNEY A LAWSON 2014 Checking 3825 CONESTOGA RD County CUMBERLAND X Trust CAMP HILL PA 17011-1417 Certificate C .`�_.�. ,y O —c � �7 � � � mrn ,�:�� `��' C�' � vs � � �� BANK oF AMERICA NA provided the department with the information below indicatin�> `�' J W� � the above-named decedent you were a joint owner or beneficiary of the account ide�i�d.�th � eat 'o � � �� Account No.68100451521806 Remit Payment and Forms to: �;:`'' y ~ � Date Established 03-28-2003 �1 � m REGISTER OF WILLS W �' a Account Balance $ 17,625.02 1 COURTHOUSE SQUARE � Percent Taxable X 33.333 CARLISLE PA 17013 Amount Subject to Tax $5,874.95 Tax Rate X 0.150 Potential Tax Due $gg1 24 NOTE': If tax payments are made within three months of the With 5%Discount(Tax x 0.95) $(see NOTE`) decedenYs date of death,deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date of death. PART gtep 1 : Please check the appropriate boxes b � @IOW. A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 27 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 Potentia/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 reve�se. 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. Comp/ete Parl 2 and art 3 as a P pp�opriate 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 ' heritance 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 � If ou are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), Y — please obtain a written correction from the fenanciai inst":tes*ion�nd attach i!*�this orm. 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 accountser of olwne s n�l d ng the decedent r(Fo hexamplef 2 o ne se p50%n3 ownersbl 33.33°%/4 ownetls by the total numb =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 sub�ect to tax 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent \\\\\\ \ \ \\ � ` ��\o�k�� -�\\��\�� e\\�� \� ��\ �\ �\\��\ �� If indicating a different tax rate,please state ��,��`� � ��,�., a�� `��`��\��`��; �� \�\\�� Y�a:c� \�� ' �� \�`\`\\\\ \�\��\��\ our relationship to the decedent: �� \��,�,��, � �� `� `�� \ \ ��\�\\�� \��\�\ �Y\� � Y ��\��\\�\\\\��\��\\��\��\\ 1. Date Established 1 ��\,�\�\��`��`\\ ��\��\��\ ��\\ ,�� \��o � � �� \��\ \��\��p�\�\��\\��\\\�� 2 $ �\` \��\\\\�\\�\\��\\\\��\�\��\��\�\�\\, 2. Account Balance �\��`�� \\� �� a X �� \��\\�\ \�\� ��\��\\\\��\ ��\�� \�\, 3. Percent Taxable 3 �;��\��`��\�� a�\�� _. @ ��- ��, �.. �� O �� \ '�� 4 ,V �� \��q��\\\��\\\�� \�\� ��\�; 4. Amount Subject to Tax �`�`��``��"��`��``�`�� `��\\\ \a \\ �� . � : � �. � \�� \�� :. \�� o� ��\��\��\��\��qv �\��\��C�� Debts and Deductions 5 - '��,��\��\��\� ��\�� r�� 5. � � \ �\ \ \��\��e�� ; @ ��\\��\\��\\�`\\�\�\��\\�,�\�\��\�\\��\\\��\��\\\�\ 6 �P ��\�\\��\��\��\ .� \\�� g. Amount Taxable �� 7 v �� \�\u\�\ O��kti��p�\��\��a\��\ � . .. /� —' ��.. � � \� ��\ � ��\\� �� \�\�� Z 7. Tax Rate ��` � �� @��\\��\\��\�o�� o\��\��\��\��0�\��`��`�\��\\�\�\��\��\a��\�� 8. Tvc Due 8 $ ��o��\�\\�\��\��o��`\��\�� X ��`��Ya\\a:��A\�\VAA\\�AAA��AAVAA��AA��a��:��A��\�A��c�\V��\�\\�� A��\\�AA\��.��\�AA g. With 5% Discount(Tax x .95) 9 Step 2: Sign and date be�mentRotu areTmaOk ng Che ks musgbe made payable oegReg s�e ofIWillseAgent e Donnotfsend°rm, along with a check for any pay Y 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 l � S �� ( Taxpaye ignature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTA�CT DIV S ON LATN717D$P 832MEN SERVICESEFOR DISTRICT OFFICE, OR THE INHERITANC TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU OF INDIVIDUAL TAXES � pennsylvania Po BOX Zeo6o1 Pennsylvania tnheritance Tax HARRISBUR6 PA 17128-0601 Information Notice DEPARTMENT OF REVENUE And Taxpayer Response WEV-1543 EX DocEXEC �oe-,Z, FILE NO.2114-0317 ACN 14162833 DATE 11-24-207 4 Type of Account Estate of OLGA DELPINO SSN 156-30-6086 Savings 2014 Checking BRADLEY C LAWSON X Trust 3825 CONEST06A RD County CUMBERLAND CAMP HILL PA 17011-1417 Certificate c� � � � � �r c� � � � � � ca � � n � Cn x7 � .� f"' � _�-�d C7 ,,,, .:�' f7't N �..r� �ri � �'� .:':� 4..7 � � � , , a � �'a e.J =..a � ';f �.� <.;� L, ��, � ,. t � � Rl BANK oF AMERICA NA provided the department with the information below indicating that at tf�dea�� the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.68100451521806 Remit Payment and Forms to: Date Established 03-28-2003 Account Balance REGISTER OF WILLS $ 17,625.02 1 COURTHOUSE S�UARE Percent Taxable X 33.333 CARLISLE PA 17013 Amount Subject to Tax $5,874.95 Tax Rate X 0.150 Potential Tax Due $gg1 24 NOTE*: If tax payments are made within three months of the With 5% Discount(Tax x 0.95) $(see NOTE`) decedenYs date of death, deduct a 5 percent discount on the tax - due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the a p � ppro riate boxes below. 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. P�oceed to Step 2 on reverse. Do not check any other boxes and dis�egard the amount shown above as Potentia/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. � 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. Comp/ete Part 2 and art 3 as a P ppropriate 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 othe�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 � If ou are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), Y pl�ase obtain a writte�carrect�an f:crrs t�e#inancEa!irstBis�::��and�tt3�h:t tu this or�n. 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. Fo�the totalcnumber of olwne s n�l d ng the decedent r(Fo hexamplef 2 o ne se p50�/n3 ownersbl 33.33°%/4 o w ers by =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 mu ltip lying t he a c c o u n t b a l a n c e b y 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 sub�ect to tax 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent \ \ \ � �� !�� °�� °`` �� \��\�\�� Vg �� \ �.\'. ��\��\��\�O\��\��\-�� If indicating a different tax rate,please state � �� ,� �� ,��,��, ecedent: �7v'Un�Sc`� ��`�� I fl$�'ll to the d ( ��. ��\\\�\\��`�"�F�� \��0 �� \��\��\�� our relato {� ��\�\\s\�\�\:��\�;� ��`��`��\\��\\�� ' �\��, O��\ o\\ y -Z.�. Z�p� ��\��\��\��\��\\�\�\\��\�\\\��\\\\�\\`��\��,``�� 1. Date Established 1 U3 ��\\��0\\��\��\\� , ��\�:�� \\�\��\��\�� \\��o\�� S l�Z. �� \� ��\��\��\\��\�\\\��\�\��\\��o�\��\�\\��;�`��\ 2. Account Balance 2 $ � �. (o L ��\��\��\��`��\�\�\��\�� x 3 3. 33 3 �� , �� ;�� , � � � 3. P@fC@IItTaX3b�@ 3 ��AA��V�VA�A��\��A��V��oVA��,AV�� / (q �� 4. Amount Subject to Tax 4 $ �0 � �+ 1� ��A��V��VAV��A��V��\i�VA@��\��A��V��A��A��a 5 - � ��AV��V�\�A�\�AVA�\��A��o��A��A\��A��VA��A rJ. �@bt$clf1C� �2C�UCtIOfI$ J� V� ��A�\v��A\\ ��A�� A \��AV � (�7�l° 1� ��A�Ay 0��A��A��\��AAVA�V`�V�V�\V�\yA�A��\V��y�� 6. Amount Taxable 6 � 5 � � �\��\�` � ��`�� "``�" � \�\��o A A��A �� Ay�� A�� 7 ,, ,_�� y�v�O �� 0vy��0�v��v��yyQ��v�vyy��yy y ��o�GO�� . � � x .�� Tar.Rat., �� /� �� A� �A��p��AV A��A\�A�� . ��` VQA� � � A�� A \�� $. T�1X �U2 8 � �.lU�• �� o��\�V��AOVA�A�� AV��OV ��A�A�V��A\�\�A�tVA��°� A ; � ��\a�� A�� X �.��\�\a\��\�\\\\��\\�\.�\:.�a:o\\�.\�o�\��\\�.��\�\�p��\u�\�:,\..�\��\\\„a...m� .�'.\ai g. With 5% Discount(Tax x .95) 9 Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wilis 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. Wprk ,v� - �US �3`� Z� i � .� ��_�— Home � l� ' C��1 s�- �� Taxpayer Signature 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 TH �� 'Y! �C 429 SOUTH 18 STREET CAMP HILL,PA 17011 PHONE: 717-730-7310 E-mail: mikeban�s(a)verizon net FAX: 717-^,30-7374 MICHAEL L. BANGS,Attorney-at-Law WENDY K.STRAUB,Paralegal WILLIAM E. MILLER,JR. Of Counsel December 18, 2014 Lisa M. Grayson, Register of Wills Cum�berland County Courthouse c � � m One Courthouse Square o m Carlisle, PA 17013 w �' � �' �' � c� c,� � �T+ s � z3r,. � N � � RE: Estate of Olga DelPino .�.r �, _.,: Fi le No. 21-14-0317 �'�; �..� '` --� `;� .� °-� c� � � T._ --ri Dear'VIs. Grayson: :"' i ►--� r rn ..;:3 � �"` . (Jl U9 ,O s::� w i-� Enclosed you will find separate PA Inheritance Tax Information Notices for Courtney A. Lawson and Bradley C. Lawson that I file as part of the above-referenced estate. Very truly yo��rs, �r�ichael L. Bangs wks Enclosures � 0 ¢ a � �� J�. � � (D d�.'�.om� •m ¢x�-o •--♦c N�� w¢ ��}o � Q o � ��_� �� M � .�=� �� r � � �= � ��r+ i-� 'i-i w +-�+ � � �� sw � �cwU � h� O � � W F � �„�j ��-M-1 �� 0 �U � � � .� o � cn �7 C� � � a" � �.,, �. W �,`�a �_ cw � ..fl U � c� ..,. •--r - ...• -- �: � � a� � �,� �I,,~ � � c� C,.,, �-1 U O U C:� CM:� �` � C , I�J t.t, CV A:7 te� .�_,. C� h M, Cy l,i.% .:" "'x � � -J .�;r ,...:I !1.! � � � �� . � � � � � ti � �.