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Home My WebLink About03-19-15 commorvwencn oF ee�utisv�vnn�iR Fev-1 t e2 exP� 961 oeaaarmeN.or Aeverv�e nu ov irvmvioun�racss oear.zeoeoi IIPPPIS9V1iG.GP1]IIB�C601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020378 EDWARDS KAREN T 5321 PEACH ORCHARD PT HECTOR, NY 14841 ACN ASSESSMENT AMOUNT CONTROL NUMBER 15501095 53,099.09 ESTATE WFORMATION: ssN: FILE NUMBER: 2115-0030 oECEOErvr rvaME: TRISTAN FAITH B DATE OFPAYMENT: 03/19/ZO1 $ � POSTMARK DATE: 03/19/2015 � couNrr. CUMBERLAND � DATEOFDEATH: 12/21 /2014 � � TOTAL AMOUNT PAID: 53,099.09 REMARKS: CHECK# 102 INITIALS: CJ sea� RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS ouaeau or �xoiv�ow� *nxss pennsylvania lnheritance Tax �, ,+� Pennsylvania vo aoz zeosoi �,� OEVpPTMENTOFPEVENOE �uux�seures rn �n�e-osoi �f110ffTl8t1011 NOtICE p.�_1F4,,�.po�,.�� o..,, And Taxpayer Response �,_��_. _ . - . RLEN0.2116-0030 '�- -�- ' � �- " AGN 15501095 - ' � ' �' DATE02-1�4015 '�15 �h� L� ?��I ="_. �5 Type of Account Es�ate o�FAITH B TRISTAN Securiry � � . X SEC Accl � � DateofDeathl&21-201a Stock KAREN T EDWARDS � CounlyCUMBERLAND Bonds 5321 PEACH ORCHAFO PT HECTOR NY 14841-9703 MERRILL LYNCH provided the department with the information below indicating that at the death oi[he above-named decedent you were a joint owner or beneficiary of the account identified. Remit Paymen�an0 Forms to: AccounlNo.87241710 Date Established REGISTER OF WILLS Account Balance $362,466.53 7 COURTHOUSE SOUARE CARLISLE PA 17013 Percent Taxable X 20 Amount Sublect ro Tax $72,493.31 Tax Rate X 0.045 NOTE': If tax payments are matle within�hree months of�he Potential Tass Due $3,26220 decedenCs date of death,deduct a 5 percent discount on the tax With 5%Discount�Tax x 0.95) $(see NOTE') $ 3 094.0�-/ due. Any inheritance tax due will bemme delinquent nine months ��`�3, �� 1 afler�he da�e of dea�h. � PART SYep 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. Pmceed ro Step 2 on reverse. Do not check any other boxes and tlisregard the amount shown above as Pofential Tax Due. g ❑The information is 7he above informa�ion is correct, no deductions are being taken,and payment will be sent correct. wilh my response. Proceed to Step 2 on reverse. Do not check any ofher boxes. � �The tax ra�e Is incorrect � 4.5% I am a lineal beneficiary(parent,chiltl,grandchild, etc.)of�he deceased. (Select correct�ax rate al ri9ht, and wmplete Part � �p� I am a sibling of ihe deceased. 3 an reverse.) � 15% All olher rela�ionships(including none). p �Changes or deductions The information above is incorrect antl/or debts and deduc�ions were paid. listed. Complete 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 tau paid wi�h the PA Inheritance Tax inheritance taz form Retum filed by[he estate representative. REV-1500. Proceed ro Step 2 on reveise. Do not check any other6oxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allawable debts and deduc�ions mus�meet bolh of Ihe following cri[eria: A. The decedent was legally responsible for payment,and[he estate is insufficient to pay ihe deductible items. B. Vou paid the debis aRer the death of ihe decedent and can furnish proof of payment it requested by the department. Qf additional space is required, you may attach 81/2"n 11"sheets of paper.) Date Paid Payee Description Amoun�Paid Total Enter on Line 5 of Tax Calcula[ion) $ PART Tax Calculation 3 N ou are makin a correc[ion to ihe establishment tlate Line 1 account balance Line 2 ,ar y g ( ) ( ) percent taxable(Line 3), pleau obWin a written correction from�he tinancial ins�itu�ion and attach it to ihis tortn. 1. En�er�he date the accoun�was established or titled as it existed at lhe date of death. 2. Enter�he mtal balance of the account including any in�eres�accrued at�he date of dealh. 3 Enter the percentage of Ihe account Ihat is taxable to you. a. First,determine ihe percentage owned by the decedent. i. Accoun(s[ha�are held"in�rust bf another or o�hers were 100%owned by�he decetlent. ii. For joint accounts establishetl more than one year prior to the date of dea[h,ihe percen[age taxable is 100%divided by�he total number of owners including the decedenL (For example:2 owners=50%, 3 owners=3333%, 4 owners =25/,etc.) b. Next,divide ihe decedenfs percentage owned by the num6er of surviving owners or beneficiaries. 4. The amount subject to tav is determined 6y multiplying the account balance by�he percent�axable. 5. Enter the�o�al of any debts and deductians claimed from Part 2. 6. The amount[axable is de[ermined by subtrecting the debts and deductions from the amount subject to tax. Z Enter the appropriale tax rate from Step 1 based on your relationship to the decedent. If indicating a diflerent tae rete,please slate OffIC18I USC OOIY:Q AAF ;7(. your relationship�o�he deceden�: Pp Dep8rtment Of Revenue � i- 1. Date Established 1 � � 2 accountsaiance 2 $ F'A�� 3. PercentTaxable 3 X � 4. Amount Subject ro Tax 4 $ 2 g 5. Debts and Deductions 5 - 4 . 6. AmountTaxable 6 $ S 7. Tax Rate 7 % 6 - 8. Tax Due 8 $ � 8 9. With 5% Discount(Tax x .95) 9 X . .St2P 2: Sign and da[e below. ReNm 7W0 comple�ed and signed copies to ihe Register ot Wills listed on the front of�his form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,AgenL" Do not send payment directly to ihe Depahment of Revenue. Under penalry of perjury, I declare ihat the facis I have reported above are tme,correct and comple�e�o�he best of my knowledge and belief. }� q/ �7 Work /✓h� / l�u-Pir-'�-J7'�Gi�JCMP�. Home L�o7�S'-l� "79'1S (/3_� 7-l� 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 HEARWG AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 , -� ,.;,�,�;�o�± �,, , r` , . ., � �� '�-. _:y. ��' � - � � ; r = � i ; � i: — ,�_�'`.�,� ,, _ { __ ' � � M __ : t$ � � - _ `I ' � - , � � _� v.�> � _. J � � � C� � ,,, � �� ,�� `, � ; � o � ` 'iN ;� _ ��:'. 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