HomeMy WebLinkAbout02-17-15 a�xcau o� rNo�vmwi raxes
Po eax zeosoi Penns IVBpI
uaxurtavz� an vpa-ow� v a �nhedtance Tax �� � �- p@nnS lVa
Information Notice . DePqq,MENry qE E n�a
And Taxpayer Response °���_�•�oo...� . ,y,
FILEN0.21-�5'OIQO
ACN 75708006
DATE 02-13-2075
Estate of CARRIE G MALONE TYPe�fAccounf
CAROLVN l MqLONE SSN 184-46-2338
Po BOX 1003 Dateo(Death09-18- Savings
BELLEVIL�E Pq 17004- Checking
I 003 Trust
CertifiCate
�
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` a � .� r
KISH BANK J <� � } � � .
provided the department with the information below indicatin '
above-named decedent ou �- �'
Y were a joint owner or beneficia 9 that at[he death of the '
Account No.633097 ry of the aCCounf identlfied. -n
Date Established 77. Remit Pa � � �
23-2072 Y^�^�antl Forms to:
Account Balance REGISTER OF � w ��
PercentTaxable $�•548.82 WILLS � : �- r�`�
X 50 � COUqTHOUSE SpUARE � �' =' �'
Amoun[SubjecttoTax CARLISLE pq pp13 �� -�i
Tax Rate $��4_4�
Potential Tax pue X 0.150
With 5%Discount(Taz x 0 gs $ ��6.16 NOTE': If(ax a
� 1 �see NOTE') P Yments are matle wi(hin three months ot Ihe
decedenPs date of death, deduc[a 5 percent discount on the tax
after the tlate ofttlea�hfax due will become delinquenf nine months
PART S.te �; P
i p Please check the appro riate boxes below.
^ ONo tax is due.
I am the spouse of the deceased or I am the parent of a decedent who was
z1 years old or younger at date of death.
Proceed to Step 2 on.everse. Oo not check any o�her boxes
shown above as Potential Tax Due.
B The information is and disregardlhe amount
correcL rhe above information is correct, no tletluctions are bein
with my response.
Pmceed fo Ste 2 9�aken,antl paymen[will be sent
P on ieverse. Do not check any other(�pxes.
C T�/ The tax rate is incorrect.
(Select correct tax rate at � 4'$� I am a lineal heneficiary(parent,child, grantichiltl, etc.) of the deceased.
right,antl Complete Part
3 on reverse.) � 72/
�am a sibling of the tleceased.
❑ 75� All other relationships (including none).
D �Changes or deductions The information above is inwrrect antl/or tlebts and tleductions were
listed.
Complete pyn p antl part 3 as appropriate on fhe back o/�his/orm.
paitl.
E ❑Asset will be reported on The above-itlenti/ied asset has been or will be reportetl and tax
mheritance tar form Retum liletl by the estate representative.
REV-7500.
Proceed to Step 2 on reverse. Do no[check an other �id with the Pq�nheritance Tax
Y boxes.
Please sign and date the back of the form when finished.
r�
pART Debts and Deductions
2
The decedent was legalry responsible tor payment,and the estate is insuHlcient to pay lhe deductible rtems.
A�lowable debts and deductions musl meet both of the following criteria.
A.
(If addilional space is required,you may attach 8112"x 11" sheels of paperJ
g. You paid the debts after the death o�ihe tlecedent and can fumish proof of payment if requesled 6y ihe A�o n`Paid
Description � ��, n.
PaYee �F ��,
Date Paid _ c^ %- �' '
;o.•.�� � � /�- '
Total Enter on Line 5 of Tax Calcu�ation) $
TaxCalculation a� rcenttaxable(Line3),
pAHT
please abtain a written correction fram the iinancial institutio�an0 attach it to this form.
3 ��you are�k�^9 a correctlon to 1he establishmeni dale(Line 1)account balance(Li�e .
interest accmed at 1he date o�death.
�. Enter the date the account was eslahlished o�litled as It existed a[the dale ot deat .
p. Enter the total balance of Ihe account including any
g, anteFirsl,determirneelhe percent getownedtby he decedent. �centage t�able is 10�%divided
le:2 owners= 50%,3 owners=33.33%,4 owners
ii. For jo n[accojunts esldabl shed'mo�ahan oneryeaeP�or�to the dat of deat t the�yeden
by the totai number of owners including�he dehe numbeFoof su mP�ng owners or beneficiaries.
=25%,etc.)
b ryex�,divide the decedent's percentage owned by
q, The amount sublect ro tax'�s determined by mul[iplyin9 the acwunt balance by�he percent taxa �
5, Enter the total of any debts and deductions claimed from Pa�Z�
g, The amount taoabl�e1estax ralelfmm Stepbtrbaeed on Y�u6�elatiotlsh p�o the de�e�aa'Use Only �� t ��
7. Enter ihe app P �Qase state PA DeP2��t���e��e
If ind'�cating a diHerent lax rale,p _ .
you�relatlonshlp to tha decedenc �� _ pAD
�, Dale Established � $ �� .,� �
p, PccountBala��e X � �2
3_ PercenlTexable 4 � 3
q. Amount Sublec[to 7ax � q
5 ' `�� $
5, Debts and Deduciions 6 � 6
6, pmountTaxable 7 X �� 7
�, Tax Pata e $� $
8. Tax Due . . . . : . : .
g_ Wlth 5%Discount(Tax x .95) 9 X � ister of�"1111s,A9eo1� Do not send
leted and signed cop�es to the Re9�sler o�Wills listed on the iront of this orm,
a ment you a�e making. Checks must be made payable to"Fleg
Stgp '2: Sign and date below. Retum Nd�comp
along with a check for any p Y knowledge�
payment direcily to the DepaAment of Re�enue.
Under penairy of perjury, I declare that the facis I ha�e rePorted aWofkare tme,cortect and complete to the best o my
bellef. +-_ i= _ _�%;�
Home 717�- � - Date
'� � Telephone Number
Taxpayer Sig�iature
� � � ` CONTACT PENNSYLVANIA DEPARTMENT OF REVEN
IF YOU NEED FURTHER� ASSISTANCE,
DISTRICT OFRCE, OR THE INHERITANCE TAX DIVISION AT 717-787-$32�' SERVICES
TAXPAYERS WITH SPECIAL HEARING ANDIOR SPEAKING NEEDS ONLY: 1-800-447-3020
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