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Home My WebLink About02-17-15 LOMMON W LHLiII OF PErvrvSVLva WF HCV-1182 E%i 1',J61 :�U�OF NCi9CVPLiP%ES w.H0.i59CP6�P+l.l]A 06C1 PENNSYLVANIA RECENED FROM: INHEflITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020244 SHUEY DIANNE H 1209 MONTROSE CIRCLE MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER 14165777 � 5153.25 ESTATE WFORMATION: 55r�: � RLENUMBER: 2114-��$3 oeceoeN7 NnmE: MCLAUGHLIN GAYLE H DATEOFPAYMENT: O2/17/2015 I POSTMARKDATE OZ/1Z/2015 couNTv: CUMBERLAND '.. DATE OFDEATH: il/27/2013 ; TOTAL AMOUNT PAID: 5753.25 REMARKS: CHECK# 338 INITIALS: CJ seA� RECENED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS aEcisTEa oF wius e�Ru� or ,.o��o�� .�,ES ' Penns Ivania lnheritance Tax �� pennsylvania PO BOX d00601 � Y r�: HRRRISBORG PA ll1�B-0601 Information Notice OEPARTMENi OF HEVENOE And Taxpayer Response "` """°°"""°°". Fi�E No.zi i a-ooas ACN 14165717 DATE 1&09-2014 rype of Accaunt Esta�e of GAYLE H MCLAUGHLIN Savings Checking Date of Dea�h 11-27-2013 Trus� OIANNE H SHUEY CO�ntyCUMBERLAND Certi�icale B00 FORBES RO CARLISLE PA 17013-1716 rNc BANK NA provided the department with the informa[ion below indicating [hat at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Hemit Payment antl Forms to: Accoun[No.5140425185 Date Establishetl 07-01-1961 REGISTER OF WILLS �� AccouN Balance $20,433.15 1 COURTHOUSE SOUARE =;- � _^ ;�;� T� CARLISLE PA 17013 ; -� m => � Percent Taxable % 16.667 _� � - , Amount Subject to Tav $3,405.59 '� �-' Tax Rate X 0.045 ' �- � � � '� :. Potential Tax Due $15325 NOTE': If tax paymenis are made within Ihree months of the �� '��- decedenfs date of death, deduct a 5 percent discguntvq ihe tax_ ' Wi�h 5% Discount(Ta�c x 0.95) $(see NOTE') due. Any inheritance tax tlue will become delihquent o�e monihs; afterthe date ofdeath. � - i �'� PART StBP 1 : Please check the appropriate boxes below. � �� %i 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. Proceetl fo Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Pofenfial Tax Due. g �The intormation is The above informa�ion is wrrec�,no deductions are being taken,and payment will be sen� carrect. wi�h my response. Proceed m Step 2 on reverse. Do not check any ofher boxes. � �The tax rete is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grendchild,etc.)of ihe deceased. (Select correCl tax rate at right,and comple[e Part � �p� I am a sibling of the deceasetl. 3 on reverse.) � 15% All other relationships(including none). p �Changes or deductions The informa[ion above is incarrect and/or debis antl deductions were paid. listetl. Complete Part 2 and part 3 as appropriate on the back ol this torm. E �Asset wi�l be reported on The above-identified asset has been or will he reported and tax paid with ihe PA Inheritance Tav inheritance tae form Retum filetl 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. I PART Debts and Deductions 2 Allowable deb�s and deduc�ions mus�meet both of Ihe�ollowing criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. Vou paid�he debts aher the death of Ihe decedent and can furnish proof o�payment if requesled by the depatlmen�. Qf additional space Is required,you may attach 81/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 H you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a Wfittert Conectic^iror!��ne financial instnution and eaaCh ii io iiiis iunn. L Enter ihe date the account was established or titled as it existed at the date of tleath. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter�he percenta9e o�the accounl that is laxable�o you. a. First,determine the percentage owned by the decedent. '. Accounis ihat are held"in tmst for"anolher or others were 100%owned by[he decedent. ii. Por joint accounts established more than one year prior to ihe date of death,the percentage taxa6le is 100%divided by the to�al number of owners including the decetlenL (For example:2 owners = 50%,3 owners=3333%,4 owners =25%,etc.) b. Next,divide the decedenPs percentage owned hy the number of surviving owners or beneficiaries. 4. The amount subject to tae is determined by multiplying the account balance by the percent ta�cable. 5. Enter[he rotal of any debls and deductions claimed from Part 2. 6. The amount�axable is determined by subtracting ihe debts and deduclions from Ihe amoun�suhject ta�ax. 7. Enter the appropriate tax rate from Step 1 hased on your relationship to the decedent. If indicating a different tax rale, please state ��S@OIl�x�� ,�-�[' . your relationshlp to the dacedent: '� �]{ [�@IIUB'_��, 4 . 1. Date Established 1 ;,� � f � . 2. Accoun�Balance 2 $ �A� �� ' � �' „ ;,-�.x;. � K-. � fi t x.+ . �. �.�. 3. PerceniTaxable 3 X 2.:. �' � �y,�� , k�' W-� '�'�" ��;. ,'K"^!s� 4. Amounl Subject�o Tax 4 $ � �`"`�'.�. f�:, '� 5. Debts and Deductions 5 - �Q-��f �:�;,�� 6. AmountTaxable 6 $ � ,,:�:s;1�` �; {��"�,,.,�; '_, ,�:r,��... ` -i � Tax RatP 7 X —._. .__._____ s '." .�.. p " :. �". . 8. Ta�c Due e $ S ;,w'��, � `� " '^•,.�$'ui' 9 W'th 5%Discount(Tax x .95) 9 x -- S�QP 2: Sign and date below. Retum TNO completed and signed copies to the Register of Wills listed on ihe front of�his form, along with a check for any payment you are making. Checks must be made payable to"Aegister of Wills,Agent" Do not send payment directly to the Department of Revenue. Under penalry of perjury, I declare that�he facts I have reported above are true,correct and complete to the best of my knowledge and belief. � � � -WOfK � , ,�0.-.. .�z � � - Home � '� � - �-'��3 Taxpayer Signature Telephone Number Date� / j � 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 -;;3;s--Y----- , � ��. , ,; , '� ` — r, :`;',,', ' = r" � .` ,' = i i � f� "� ? _ 4 '' � _ . „�-� m �_ � \"� �/� � != \ " i 1� = � ' � � � - :� : � n� = f� � � � �' �,� � �� .J � �n �� , � �� .. � - - ��,:r�� - _ , ,��o � ; � i ��qi" � Wd Gi �3� ;:0� > � 0u C � � �� .., .i��V 1 ?ry£ _�.. �J��3L�