HomeMy WebLinkAbout03-13-15 (2) earzeno oF �xorvmun� rnxes Pennsylvania lnheritance Tax '�� pennsylvania
PO BOX �B06o1 DEGNflTMENTOFFFVENOE
NARRISBORG PR ll128�0601 Information Notice
And Taxpayer Response Fi�E No.zns,000�¢ `o� Lz1
.__.. _. . . . . . . .. -
.�,_�.. . . . ,. , ; ,- ACN15501340
. � .. DATE 02-25-2015
�-�'_S �hll �� YI� �l 1� TypaofAccount
Estate of MARLM L STEVENS Security
� �� � X SECAcct
,- � - Date of Death 12-17-2014 Stock
CORRINA D WADEL U��� . � . . � � , CountyCUMBERLAND Bonds
ll HILLTOP OR C'�`��'- � . ,
SHIPPENSBURG PA 17257-8001
EDWARO JONES 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.896 Remit Payment and Forms to:
Date Established REGISTEH OF WILLS
Account Balance $ 179,264.95 1 COUHTHOUSE SOUARE
Percent Taxable X 50 CAHLISLE PA 17013
Amount Subject b Tax $89,63248
Tax Ra[e X 0.045 NOTE': If tax paymenis are made within ihree months of the
Potential Tae Due $4,033.46 decedenYs date of death, tletluct a 5 percent discount on[he taa
With 5%Discounl(Tax x 0.95) $(see NOTE') due. Any inheri�ance tax due will become delinquent nine mon(hs
after the date of death.
PART St2P 1 : Please check the appropriate boxes below.
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.
Proceed fo Step 2 on reverse. Do not check any other boxes and tlisregard fhe amount
shown above as Potential Tax Due.
g �'The intorma�ion is The above information is wrrecf, no deauciions are being taken,and paymani will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any ofher boxes.
p �The tax rate is incorrecL � 4.5% I am a lineal beneficiary(parent, child, grandchild, etc.)of the deceased.
(Selecl corred�ax rate a�
right,antl complete Part � �p� I am a sibling of the deceasetl.
3 on reverse.)
� 15% All o[her relationshlps (including none).
p ❑Changes or deductions The information above is incorrect and/or de6ts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriafe on fhe back ol this lorm.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with ihe PA Inheritance Tax
inheritance tax iorm Feturn filetl by the estate represenlative.
REV-1500. Proceed to Step 2 on reverse. Do not check any ofher 6oxes.
Please sign and date the back of [he form when finished. �(, °.
�
PART Debts and Deductions
2
Allowable debis and deductions must meet both of ihe following criteria:
A. The decedent was legally responsihle for payment,and the eslate is insufficient�o pay the deductible items.
B. Vou paid the tlebts after ihe death of the decedent and can furnish proof of payment if requested by ihe department.
Qf addi�ional space is required, you may atlach 8 V2"x 11"sheels of paper.)
Date Paitl Payee Descrip�ion Amount Paid
Total En�er on Line 5 of Tax Calculation $
PART Tax Calculation
3 N you are making a correction to the eslablishment dale(Line 1)account balance(Line 2),or percent taxable(Line 3),
please obtain a written correction from the financial institution antl attach it to ihis form.
t Enter Ihe date the account was established or titled as it existed a[the da[e of death.
2 Enter Ihe total balance of the account including any interest accmed at ihe date of death.
3. En�er the percenlage ot lhe account(ha�is taxable to you.
a. Firel,de�ermine the percen�age owned 6y ihe decedent.
i. Accounts that are held "in�mst tor"another or others were 100%owned by Ihe decedent.
ii. For joint accounts established more than one year prior to the date of tleath,the percen[age�a�cable is 100%divided
by�he total number o�owners including ihe decedent (For example:2 owners= 50%, 3 owners=33.33%,4 owners
=25%,etc.)
b. Next, tlivide�he decedenYs percentage owned by Ihe number oi survivin9 owners or beneficiaries.
4. The amoun�subjec[lo tax is determined by mul�iplying Ihe account balance by the percent laxable. �
S Enter ihe[otal of any debls and deductions daimetl from Part 2.
6. The amount taxable is determined hy subtracting the debts and deductions from the amount subject[o tax.
7. En�er the appropria[e�ax ra[e from Step 1 based on your relationship�o�he decedent.
If indicating a different tax rate,please sta�e OfflCj� USB�fl��[[]MF �
your relationship[o the decedent: {�q�Pa�j�pyp[pf RBV@OUB� ���,
1. Date Es[ablished 1
2. nccountBalance 2 $ PAD '
3. Percent Taxable 3 X 1 � .
a. Amount Subject to 7ax 4 $ 3
5. Debls and Deductions 5 - 4
6. AmountTaxable fi $ 5
7. Tax Ra�e 7 X S'
�. '
8. Tati Due B $ $ +< „ ��.
9. Wi[h 5% Discount (Tax x .95) 9 x - _ -
St2p 2: Sign and date below. Retum TYJO completed and signed copies to the Register of Wills listed on the iront of this(orm,
along with a check for any payment you are making. Checks musl be made payable to"Register of Wills. AgenC' Do not send
payment directly to the Depariment of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are irue,correct and complete to ihe best of my knowledge and
belief. .
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�axpayer 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: 1-800-4473020