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Home My WebLink About03-27-15 ; pennsylvania eucFnu ar �Norv�ow� TexEs PEf1f1SY�V2flld �fIhB�ItdIlCB T2% � oePnarmervr or wEvervue Po eox �s�s^� Informa[ion Notice .,,.,,.,.E.�. .�. ,oe-�. XPRRISBVRG PP ll108-�601 And Taxpayer Response Fi�E No.2��')"y-F�7�J�s RECOR F.^, CFPICE OF acNiesoieaa RE615 � '� ; - 4';:LLS onreoa-n-zo�a 70]5 �f�fl 2� �� Zz Jy TypeofAccount �I ,. �F Estate of FUTH A SNOW Security _ SSN 198-44-8468 �SEC Acct OR�F' '� _ '�', � oaie siock � � CounryCUMBERLAN� eonds DEBRA TENNEV CUMtlC. .'. . . 1702 CENTERVILLE R� NEWVILLE PA ll241-6931 RIVERSOURCE LIFE provided the department with [he information below indicating that at[he death of the above-named decedent you were a joint owner or beneficiary of the account identified. RemH Payment and Forms to: Account No.13875614 pEGISTER OF WILLS Date Established � COURTHOUSE SOUARE Account Balance $35,313.05 CARLISLE PA 17013 Percent Taxable X 100 Amounl Subject lo Taz $35,313.05 Tax Rate X 0.120 NOTE': If tax payments are made within three monihs of the Potential Tan Due $4,237.57 decedenCs dale of dealh,deduct a 5 percent discount on the t� due. An inheritance tax due will become tlelinquent nine months With 5%Discount(Tax x 0.95) $( ee NOTP) after�he da�e ot death. PART SteP 1 : Please check the appropriate boxes below. 1 n ❑No tax is due. I 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 dealh. Proceed fo Step 2 on reveise. Do not check any other boxes and tlisregard the amount shown above as Potential Tax Due. �The informalion Is The above information is correct, no deduclions are being laken,and paymen�will be sent B wrtec�. with my response. Proceed ro Step 2 on reverse. Do not check any othe�boxes. � �The lax rate is Incorrecl. � 4.5% I am a lineal beneficiary(parent,child,grandchild,elc.) of the deceased. (Select correct tax rate at riqht,and complete Part � 12/ I am a sibling of the deceased. 3 on reverse.) � 15% All olher rela�ionships(including none). p �Changes or deduc�ions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriare on the 6ack of this form. E ❑Asset will be reported on The above-identified asset has been or will be reported and t�paid with the PA Inheritance Tax inheritance tax form Fetum filed by lhe estate representative. REV-1500. Proceed ro Step 2 on ieverse. Do not check any other boxes. _ \ % Please sign and date the back of the form when finished. "�) PART z Debts and Deductions Allowable debts and deductions must mee�both of the following criteria: A The tlecedent was legally responsible for payment, and the estate is insutficient to pay ihe tleductible items. B. Vou paid the debts aRer the death of the decedent and can furnish proof of payment if requested by the department. pf atlditional space is required,you may attach B 7/2"x 11"sheets of paper.) Da�e Paitl Payee Descrip�ion Amoun� Paid Total En�er on Line 5 of Tax Calculation $ PART Tax Calculation 3 N you are makinq a corcection to ihe esWblishment tlate(Line 1)account balance Line 2, or please obtain a wriry¢�correction from tFe tinancial ins�itufion and attach ii to this�orm.� cercent taxable(Line 3�, L Enter the da�e the account was established or titled as it existed at the date of death. 2 Enter ihe total balance of ihe account induding any interest accrued at ihe date of death. 3. En�er the percentage of the account that is�axable�o you. a First,determine the percenta9e ownetl by the decedent. '. Accounts that are held"in Imst for"another or others were 700%owned by the decetlent. ii. For joint accounts es�ablished more than one year prior to the date of death,the percentage taxable is 100%dividetl by the total number of owners including Ihe decedenL (For example:2 owners=50%,3 owners=33.33%,4 owners =25%, etc.) b. Nezt, divide ihe tlecetlenPs percentage owned by the number of surviving owners or beneficiaries. 4. 7he amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the btal of any debts and deduclions claimed from Part 2. 6. The amount taxable is tletermined by subhacting�he tle6ts and detluctions from the amount subjec�to tax. 7. Enter Ihe appropriate tax rate from Step 1 basetl on your relationship to the deceden[. If indicating a diRerent taz ra[e,please state � your relationship m the decedent �C�21 Use Only,[�qqp . �. oace Es�abrsned i PA Departmentof�.Revenue`, rs >;. .. 2. Accoun� Balance p $ PA� � "�_' 3. PercentTaxable g X 1 xi „� 4. Amount SUbjec�to Tax q $ 2 -1`„� 's 5. Debts and Deductions 5 - 4 � 6. Amoun(Taxable 6 $ S . ! ' 7. T� Rate 7 X 6 =��' i.-' 8. Tax Due g $ .. .- --'—��- I7 9. Wlih 5% Discount(Tax x .95) 9 X $ SteF1 2. Sign and date below. ReNm T4V0 completed and signed copies to the Register of Wills listetl on the 6ont of this form. along with a check for any payment you are making. Checks must be matle payable to"Register of Wills,Agent" Do not send payment directly ro the Department of Revenue. Untler penalry of perjury, I declare tha[ihe facts I have repotletl above are Irue, correct antl complete to the best of my knowledge and belief. � �-- Work � o -�-�-� _ _ _ Home '? 17 U86 �3? 13 j��- Taxpayer Signature � Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-7g7-g3p7. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-8p0-447-3020 1 S q k '� _ i'� �� j� = �0 \�i�� = � _M = `a LL `.,�) f� r' - ;; � 3 = � c . _ � � � �� _ � y � � � _ �".: � � � r � - � � � �„ ir, � J � �. i)7 (�3 ('1 :''') I'� � �.,� � . :i'�'�i./i(i0 �� ;ti��Haba � � � 3�� r = F t 4 � � °� h6 ZT Wti L� N8W Sluc a � � 0 3 s-�-,�,, � __ _ i�3a � �- z , �03�1_�� 9;i0�323 . �