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Home My WebLink About03-02-15 (2) BUREAU OF INDIVIDUAL TAXES Penns lvania Inheritance Tax pennsytvanla PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE "-"'"""_""'� REV-1543 EX Doc EXEC (08-12) And Taxpayer Response FILE NO.21 15 - 21�b ACN 15104296 DATE 01-27-2015 Type of Account Estate of MARY E FARINA Savings SSN 206-10-9824 Checking Date of Death 11-23-2014 fes, Trust STEPHEN D FARINA County CUMBERLAND Certificate 13 LEROY ST c- M POTSDAM NY 13676-1737 ` ) rn 0 J") C-3 Lr) _ METRO BANK 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.616119460 Remit Payment and Forms to: Date Established 01-27-2000 REGISTER OF WILLS Account Balance $24,186.83 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $12,093.42 Tax Rate X 0.150 Potential Tax Due $ 0.150 01 NOTE': 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') 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 F1 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 RThe tax rate is incorrect. ❑ 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-1 Changes or deductions The information above is incorrect and/or debts and deductions were paid. d. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset w' be reported on The above identified asset has been or will be reported and tax paid with the PA Inheritance Tax mheri nce tax form Return filed by the estate representative. R -1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. C/ PART F�� F��Deductions Allowable debts and deductions must meet both ofthe 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) $ PA 7-ax Calculation If you are making ocorrection tothe establishment date(Line 1)account balance(Line 2)'mrpercent taxable(Line 3). please obtain a written correction from the financial institution and attach it tothis form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance uf the account including any interest accrued atthe date ofdeath. 3. Enter the percentage nfthe account that ietaxable toyou. a. First,determine the percentage owned bythe decedent. i Accounts that are held"intrust for"another or others were 100%owned by the decedent. ii For established more than one year prior 10the date ofdeath,the percentagetaxable ia100%divided bythe total number o/owners including the decedent. (For example:2owners~50%.3owners=33.33%,4owners =25Y&.etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject totax iudetermined bymultiplying the account balance bythe percent taxable. 5. Enter the total ofany debts and deductions claimed from Part 2. G. The amount taxable iudetermined bysubtracting the debts and deductions from the amount subject hztax. 7. Enter the appropriate tax rate from Step 1 based unyour relationship tothe decedent. If indicating a different tax rate,please state Official Use Only 0 AAF your relationship to the decedent: PA Department of Revenue 2. Account Balance 2 $ PAD 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 4 . ,,.^.. ~'. ~.~.~...^`.... ~~' . Step 2: Sign and date below. Return TWO completed signed Register ofWills listed unthe front of this form, along\with acheck for any payment ynuemmeking. Checks must bomade payable to"Register ofWills,Agent." Donot send payment directly 1othe Department of Revenue. 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 o �2 b7� , I i i � 1 i �i