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Home My WebLink About02-27-15 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 020293 WEIGAND JEAN L 208 SENATE AVE APT 402 CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 15107325 $739.54 ESTATE INFORMATION: SSN: FILE NUMBER: 2115-0224 DECEDENT NAME: WEIGAND JEAN L DATE OF PAYMENT: 02/27/2015 POSTMARK DATE: 02/24/2015 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2015 TOTAL AMOUNT PAID: $739.54 REMARKS: CHECK# 1493 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAUOF INDIVIDUAL TAXES Penns lvania Inheritance Tax per11'1SJ/LVdl11a PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE REV-1545 EX DocEXED (08-12) And Taxpayer Response FILE NO.21 — C(}f�^ � J4F ACN 15107325 DATE 02-10-2015 70i5 FEB 27 lF!i 1 29 Type of Account Estate of JEAN L WEIGAND Savings C L.`_� F SSN 2015 Trust JOHN L WEIGAND 1 o H t County CUMBERLAND Certificate 3942 BROOKRIDGE DR Ctlt42- MECHANICSBURG PA 17050-2103 AMERICHOICE 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. Account No.312940018 Remit Payment and Forms to: Date Established 10-30-1999 REGISTER OF WILLS Account Balance $34,598.74 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $17,299.37 Tax Rate X 0.045 Potential Tax Due $778.47 5NOTE*: If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE*) :2�q,S_V 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 F-]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 not check any other boxes and disregard the amount shown above as Potential 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 F—]The tax rate is incorrect. F—] 4.5% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right, and complete Part F_� 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D F—]Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete 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 211 Allowable debts and deductions must meet both nfthe 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 iarequired,you may attach 81/2^x11^sheets cfpaperj Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) , $ P AR -Fax Calculation i--��—� Ifyou are making a correction tothe establishment date(Line 1)account balance(Line 2),mrpercent taxable(Line 3)` please obtain a written correction from the financial Thstitution 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 ofthe account that imtaxable boyou. a. First,determine the percentage owned bythe decedent. i. Accounts that are held"in trust for"another urothers were 100%owned bythe decedent. ii. For established more than one yearprior hothe date ofdeath,the percentagetaxab|e is 1OUY&divided bvthe total number ofowners including the decedent. (For example:2owners=5O%.3owners=33.33%.4owners =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 cdany 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 onyour relationship 1uthe decedent. If indicating a different tax rate,please state Official Use Only 0 AAF your relationship'-the decedent:— 2. Account Balance 2 $ PAD 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 Step 2: Sign and date below. Return TWO completed andsigned copies 0othe Register ofWills listed onthe front cf this form, along with acheck for any payment you are making. Checks must bnmade payable to"Register cfWills,Agont~ Donot send payment directly tothe Department ofRevenue. 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 7,57S 0 _John Weigand � �,„� •�„ +�-.,. _ f� 3942 Brookridge Dr. 7AMPA FL 335' „��• „>�^`p,- !. MechanicsburgPA 17050-2103 cr) N � �- ' o ra_ `� s CAL1S � � I ZDI3 c� c-- LAJ - Li tj N tn 1 ;'1�i�1.3��'�2'�9 ", l"il"��11�'ir`,�1'�lyiilN�'t��lt�y��1�1{)rilij:j�l►�l�ll'l�iil