HomeMy WebLinkAbout03-13-15 `�'� pennsylvania
a�R�,� or ��o���o�� ,..E: Pennsylvania lnheritance Tax ��'� ���
PO BO% �00601 �� � OEPAPTMENTOF PWENOE
XPRRISBORG PA ll128-0601 Information Notice ppr �so�[r ue¢rto ue-in
And Taxpayer Response
Fi�e No.zi i s-aoo�
,—_ . � _� . .., ACN15501339
... - . . -.. . . ... - DATE 02-25-2015
J. �';� i� ."i'i `� 1� Type of Account
� Estate of MARLM L STEVENS Securiry
-- � X SEC Accl
Q � Date of Death 12-17-201 a Stock
L[Sn M STEVENS ��;; „ �. CountyCUMBERLAND Bonds
4073 ROIITE 130
IRWIN PA 15642-7831
EDWARO JONES provided the department with [he 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.896 Remit Payment and Forms to:
Da[e Established REGISTEH OF WILLS
Accoun� Balance $ 179,264.95 � WURTHOUSE S�UARE
CARLISLE PA t7013
PerceN Taxable X 50
Amoun�Subject�o Tae $89,63248
T� Rate X 0.045 NOTP: If tax payments are made within three mon[hs of[he
Potential 7ax Due $a,033.46 decedenPs date of death,deduct a 5 percent discount on[he tax
Wilh 5%Discount(Tax x 0.95) $ (see NOTE') due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART $tEp 1 : Please check the appropriate boxes below.
t
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 to Step 2 on reverse. Oo not check any other boxes and disregard the amount
shown above as Potential Tax Due.
g �Tne information is The above intormation is correct, no tleductions are bemg taken,antl payment wili be sen[
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
� �7he tax rate is incorrecL � a.5% I am a lineal beneficiary (parenL. child,grantichild etc.)of ihe deceased.
(Selec�correc[tax rate at
righ�,and complete Patl � �p� I am a sibling of Ihe deceasetl.
3 on reverse.)
� 15% All other relationships(including none).
p �Changes or deductions The information above is incorrect and/or debis and deductions were paid.
lis[ed. Complete Part 2 andpart 3 as appropriafe on the back ol this lorm.
E Asset will be reported on The above-iden�ified asset has been or will be reporled and tan paid with the PA Inheritance Tax
inheritance tae form Re[um filed hy the eslate represen�ative.
REV-1500. Proceed to Step 2 on reverse. Do not check any ofher 6oxes.
�Please sign and date the back of the form when finished.
.�
PApT Debts and Deductions
2
Allowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment,and the estate is insuflicient m pay�he deductible i�ems.
8. Vou paid the tlebts after the tleath of the decetlent antl can furnish proof of payment if requested by the department.
Q�addi�ional space is required,you may attach 8 7/2"x 11"sheets of paper.)
Da�e Paid Payee Descrip�ion Amount Paitl
Total Emer on Line 5 of Tax Calcula�ion) $
PART Tax Calculation
3 If yau are making a correction to ihe es[ablishment tlate(Line 1)account balance(Line 2),or percent taxable(Line 3),
please obtain a written correction from the financial institution antl attach it to this form.
1. Enter ihe date the account was es[ablished or titled as it existed at the date of death.
2 Enter ihe total balance of ihe account including any interest accmed at the da[e of death.
3. Enter the percentage of the account that is taxable ro you.
a. First. determine the percentage owned by the decedent.
'. Accounts Iha�are held "in tms�for"ano�her or others were 100%owned 6y�he deceden�.
ii. For joint accounts es�ablished more than one year prior to the da�e of death,�he percen�age t�able is 100%divided
by the total number of owners including ihe decedenL (For example:2 owners=50%, 3 owners=33.33%,4 owners
=25/,etc.)
b. Next, divide the decedenfs 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 pereent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subirac[ing ihe tlebis and deductions Gom the amount subjec[to[ax.
Z Enter the appmpriate tax rate From Step 1 based on your relationship to the decedent.
if IndlcaGng a dl�rerent tax rete,please state p(�pa{.�g(���r Q�
your relationship to the decedenY. pJ��epyr[mp,nt Of R@YC(�UB ��
1. Date Established 1
2. AccouniBalance 2 S PA��
3. Percen�Taxable 3 x Z
4. Amount Subject to Tax 4 $ 3
5. Deb�s and Deduc�ions 5 - 4 .
6. AmountTaxable 6 $ $
7. Tax Ra�e 7 % s
e. Tau Due 8 9 �
8
9. With 5% Discount(Tax x .95) 9 X
.Step 2: Sign antl tlate below. Return T4Y0 completed and signed copies to Ihe Register of Wills listed on tM1e fmnt of this form,
along with a check for any payment you are making. Checks must be made payable to"Regisler of Wills,AgenC Do not send
payment directly to the �epartment of Revenue.
Under penalry of perjury; I declare that ihe tacts I have repotled above are tme,corred and complete to ihe best of my knowledge and
belief.
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payer 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