HomeMy WebLinkAbout02-24-15 H'V-11 E2 IXI11-9E1
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RECENED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO. CD 020271
BRUCE CAROLE A
5225 WILSON LANE APT 103
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
- — --
,��� 14166155 553J4
ESTATE WFORMATION: SSN:
FILE NUMBER: 2114-1171 I
oECEOErvr NaME: BRUCE JEAN M I
DATEOFPAYMENT: O2/24/2015 �
POSTMARKDATE: 02/20I2075 I
couNTv: CUMBERLAND �,
DATE OFDEATH: 11/13/2�14 I
TOTAL AMOUNT PAID: 553.74
REMARKS:
CHECK# 447
INITIALS: CJ
sEA� RECENED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OFWILLS
;°"�"° °` '"°'°10°"` �""s pennsylvania lnheritance Tax ��� � 's PennSY�VB1118
o eox zeoso�
NARqIS60RG Pn I113p-0601 Information Notice DEPPPTMENTOFREVENIIE
_And Taxpayer Response "`-", "°.` " -"
^�,,. _ . �. . . . _ ._. RLEN0.21 '�Y"�I7�.,
-..��.�.. . . .. . �„ ACN 14166155
" ' DATE12-iL2014 �
�,1� FE3 `i f,';'i l: �4
Type of Account
• . Es[a�e of JEAN M BRUCE Savinqs
- � SSN 174-20-6937 Checking
" Dateof Death 11-13-2014 Tmst
CAROLE A BRIICE � . .. � Coun(yCUMBERLAND
1103 BALDWIN ST Certificate
MECHANICSBURG PA 17055-3935
MEMBERS isr Fcu provided the department wi[h the information below indica[ing that at [he death of Ihe
above-named decedent you were a joint owner or beneficiary of the account identified.
Accoun�No.47205 �7emi1 Paymen�and Fo�ms[o:
Date Established 12-26-1984 FiEGISTER OF WILLS
Account Balance $2,388A2 1 COURTHOUSE SOUAFiE
Percent Taxa6le X 50 CARLISLE PA 17013
AmountSubjeqtoTan g �,�gq.p�
T� Rate X 0.045
Potential Ta< Due g 53.7q NOTE': If t�paymen[s are made within three months of�he
Wi(h 5%Discoum(Taz x 0.95) $(see NOTE') decedent's da�e of death,deduct a 5 percent discount on the�au
due. Any inheritance tax due will become delinquent nine months
aRer Ihe date of death.
PAAT St2 1 : Please check the a
� P ppropriate boxes below.
A �No tax is due. I I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or younger at tlate of death.
Proceetl ro Sfep 2 on reverse. Do not check any other boxes and tlisregartl the amount
shown above as Potential Tar Due.
g �The iniormation is The above informalion is correct, no detluctions are being taken, and payment will be sent
correc�. with my response.
Proceetl fo Step 2 on reverse. Do not check any other boxes.
l\�
p �The tax rate is inwrrecL � q.5% I am a lineal beneficiary(parent�c�d grandchild, etc.)of Ihe deceased.
(Select wrrect tax rate at �
right, and complete Part � 7 p� 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. Comple(e Part 2 and part 3 as appropriate on the back o/this lorm.
E �Asset will be reported on The above-identified asset has been or will be reported and tarz paid with the PA Inheritance Tax
inheri�ance��form Re�um filed by the estate representa�ive.
REV-1500. Pmceed Po Step 2 on reverse. Do not check any other boxes.
Please sign and date the back oi the form when finished.
PART Debts and Deductions
2
Allowable debts and dedudions musl mee�bo[h of the following criteria:
A. The tlecetlent was legally responsible for payment,and ihe estate is insufficient to pay the tletluctible items.
B. You paid[he dehts aiter the death ot ihe decedent and can fumish proof of payment if requested by ihe department.
(11 additional space is required,you may attach 8 VY x 11"sheets ot paper.)
Date Paid Payee Description Amount Paitl
Total (Enter on Line 5 of Tax Calculation $
PART Tax Calculation
3 N you are making a correction lo the establishment dale(Line 7)account balance(Line 2), or percent taxable(Line 3),
please abiain a writlen correction imm[ne linancial instiwtion antl attach it to this iorm.
L 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 accmed at ihe date of death.
3 Enter the percentage of the account ihat is laxable�o you.
a First,tletermine the percentage owned by the decedenl.
i. Accounts[hat are heid"in tms�for"another or others were 100%owned by the decetlen�.
ii. Porjoint accounts established more than one year prior to the tlate of death,the percentage tacable is 100%dlvided
6y the total number of owners induding the decedent. (Por 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 amoun�suhjectto[arz is determined by multiplying the account balance by the Oercent t�able.
5. Enter[he tolal of any deb�s and deductions claimed fmm Part 2.
6. The amount taxable is determined by subtrac�ing the deb(s and deductions irom the amount subject to tax.
J. Enter the appropriate tax ra[e from Step 1 based on your relationship to the decedent.
If indicating a different ta<ra[e,please state *+���p''�'��'���Jg@Qnjy[�Ap .�
your relationship to ihe decedent: �,��, � ""� ���f�yy� �'"4" �� ;
1. Date Established 1 qek 9,"��� � -:-�,�
2. Account Balance 2 $ � � �dt�qW� .��5e +�+p c• 'i»���` �, °�"�
:. �l�4`Y 1�.'R��L.�?lbeB�����. `.ax* ._ � �.
3. PercentTaxable 3 x p � '� '1- '" ."-�
.� A� t�+ ��_��� = �'� �... _ ,.
a. nmount Subject to iax a S � ����;,�������„,x�,,:�y�„�+�.- �:_ �.
5. DeMs and Deductions 5 - �¢'e * + „ ?, 3^ `
x . �� ��':. -cf •`,•.
6. AmounlTaxable 6 $ � " '�,� n �. �'��x„���N � r � s,
Z TaxReta 7 X .- �31x '1 �'4 :�� �
scA� �rc
6. TaxDue 8 S ��� �� �,�w, �.ar = �
w e � �s��-t:
9. WtthS%Discount(Taxx .95) 9 X � �"t^ ��' n�.- � �
StEP 2: Sign and date below. ReWrn TVJO completed and signed copies to the Register of Wills listed on the front of Ihis 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 ihat the facts I have reported above are true,wrrec�and complete to the bes�of my knowledge and
belief.
�����Xi�I:C�- work ��I�—�'��
Home ��('� � ��5
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
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