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Home My WebLink About02-02-15 B�R�� oF INDIVIDUAL TAXES Pennsy�vania �nheritance Tax � Per1t'1S�/LVa111d PO BOX 260601 � DEPARTMENT OFREVENUE HARRISBURG PA 17128-06 01 Information Notice '�-- �---� REV-1543 EX OocE%EL (OB-12] �ti�l��y�r,-R��p_onse FILE NO.21-�•�—�12X ��, + •��: �� . ._ ACN 14168375 �-''-_:a DATE 12-25-2014 ,�r , � �� Type of Account � Esfate of MARIE L BAKE Savings �'�r�r { � ' , X Checking �(,�,�f� �'-' • Date df'Death 11-19-2014 Trust TINA L EMERICK � ` CountyCUMBERLAND Certificate 6708 SUMMERTIME LN BURLINGTON KY 41005-6511 MEMBERS isr 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. Remit Payment and Forms to: Accou�t No.366708 Date Established 09-05-2009 REGISTER OF WILLS Account Balance $4,784.09 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $2,392.05 Tax Rate X 0.150 Potential Tax Due $358.81 NOTE': If tax payments are made within three months of the decedenYs 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 nof check any other boxes and disregard the amounf shown above as Pctentia!Tax Due. g �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 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 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 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxabie(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"in trust 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 decedenYs 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 ��`��\` " � � �� °�� ` `� �� \ � � �° � A`� your relationship to the decedent: �auc��itF +" . �V��` �` `�"` ��`�:�� `�� -� `� \ � �� A. � � ��V �� A 1. Date Established 1 OR ��5 ' � q � � �f� ��\� �� \\�� A��A�� e��\�A � � � �A\� �� \� ��e\\��\\��\\\�� ; 2. Account Balance 2 $ q- Ca�T I . Co 3 �� \�� \�� 3. Percent Taxable 3 X S� � �� , �� \�� tia��A ��h\«\� ��o�.� �� v\�\�� 4. AmOullt Sub'@Ct t0 T8x 4 $ � 3�.�. �� . � \�� \� �� 1 � ��A ��VA� �� V�\�� \u\ �� `\��\��'��\�\�\�� 5. Debts and Deductions 5 - ;� �`�� ,�� ,�� \�` �� " `�\\��`��\�r�: \�,AA �� . ��v\�� :� � ��'. �� V�\V\ 6. AmOU11t T1X1bl@ 6 � , ��J . `O� �� :��..��V� ��\��`�a�� V`��\�� 7. Tax Rate 7 X �. Q�-�j �\�� \ ,� \�� °\ �� \r��`i��a�� : ��.�\�`"�� a ��V�� V\� 8. T1X �U8 $ $ � �� . ( � ��A �A�A ��.��C� �� A �� `� �: ��\��\� �� c � . �� \ �A� \\\\�� `��`��c�� \ �� VAAV�ti\�y V��0��.A`��VA� �� V��AA�\�\A�� VA�a�VA��V�F�� 9. With 5% Discount (Tax x .95) 9 X q q. g ��?��o��.u��,��....:��.�.�: F .�, �� ...�� .��a��a��.. \o\�aa\\\��\�� 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 1 have reported above are true,correct and complete to the best of my knowledge and belief. Work ��-,��/�'lQ-�-v'�C�- Home g S� -�U a -C�C�5"�- l_ �-lS 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 Tina L. Emerick 6708 Summertime Lane Surlington, KY 41005 January 28, 2015 Register of Wills 1 Courthouse Square Carlisle, PA 17013 �-, - —�� r� � `�°, �:-� i;t Re: Pennsyfvania lnheritance Tax ; �;� � �_� Estate of Marie L. Bake � .' 'J^' c� - r..� Date of Death: 11-19-2014 , -�, � - , � _.� .. ..: _,... �:..3 Dear Sir or Madam: �" `-- ��' �, ,,, c� _ �j -;� Enclosed please find two copies of the Pennsylvania lnheritance Tax Information Notice And Taxpayer Response for the estate of my mother, Marie L. Bake. While you should have received a copy of the"correcting letter"from Members 1St FCU indicating that the Account Balance figure should have been $4,671.63, I have also enclosed a copy of that letter for your ease of reference. Finally, I have enclosed a personal check (Number 1742) in the amount of $99.86 as payment for the inheritance tax obligation. As noted,this amount contempiates the 5% discount for payment within three months of the date of death. Please do not hesitate to contact me, if you should have any questions. Thank you for your attention to this matter. Sincerely, ; � �} 1..f � �:ij��1��..i�_'t i'�,'�' Tina L. Emerick encl Pennsylvania lnheritance Tax Information Notice And Taxpayer Response (2 copies) Members 1 s`Itr dtd 1/23/15 Personal Check Number 1742 � rn � n o � . � � �, r o � � , � � �. �. � � � � A o r,., o �, � � � � �. � w• -•.I " �F n ►-� 7� ' 4�:� � n� �t � o .'. C�� rt �� . 9 0 °� , +t �7 � � . � � � � : O� N 4 � ��♦ � W W ^-s !D i�:�' — `'"" �„�:'y � _ � � '. ,^e «::: � _' ;�;. zi:„ _ N� � .,..� � ' �, �t � �� _ � � fA,� � �4�: #. �.n:. '`. �� :� p W.. i� o ,� n _ �y� � �. N �. ��i �� .. Lh 4 '... 'k. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 020198 EMERICK TINA L 6708 SUMMERTIME LANE BURLINGTON, KY 41005 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------- foid ______"" '_______ 14168375 � 599.86 ESTATE INFORMATION: sstv: I FILE NUMBER: 211 5-0128 I DECEDENT NAME: BAKE MARIE L I DATE OF PAYMENT: 02/02/201 5 I POSTMARK DATE: O 1/29/201 5 I COUNTv: CUMBERLAND � DATE OF DEATH: 1 1/1 9/201 4 I � TOTAL AMOUNT PAID: 599.86 REMARKS: CHECK# 1742 INITIALS: CJ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS