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Home My WebLink About03-25-15 (2) BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance TaxpennSyLVanla PO BOX 280601 HARRISBURG PA 17128-0601 Information Noticewl", DEPARTMENT OF REVENUE REV-1543 EX UocEXEC(08-12) And Taxpayer Response FILE NO.2115-0183 ACN 15113608 DATE 03-16-2015 Type of Account Estate of HANNA SCHREIBER Savings SSN Checking Date of Death 01-01-2015 Trust RICHARD SCHREIBERMD County CUMBERLAND Certificate 301 ROBINSON RD NEWPORT PA 17074-7351 ter) J-n�, C G- C� C f-71 , Lr1 r a PNC BANK NA 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..; v ) Remit Payment and Forms to: Account No.5000706209 Date Established 04-17-1996 REGISTER OF WILLS Account Balance $32,713.64 1 COURTHOUSE SQUARE G Percent Taxable X 16.667 CARLISLE PA 17013 Amount Subject to Tax $5,452.38 Tax Rate X 0.150 Potential Tax Due $817.86 0NOTE`: 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 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 ❑The 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 ❑ 12% 1 am a sibling of the deceased. 3 on reverse.) 15% All other relationships (including none). D ❑Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PA / ��o�� r� | =�="= ��O~� =�=U�"ons 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 iorequired,you may attach 81/2^x11^sheets ufpaper.) � Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage mdthe account that iotaxable toyou. a. First,determine the percentage owned bythe decedent, L Accounts that are held"in trust for"another orothers were 10D%owned bythe decedent. / ii. For 'accounts -am ` established mpercentage rnentageiaxob|eiu1UO��dividod | bthe number ofowners including the decedent. (For example:2owners" 0%.3owners~33.33%.4nwnnrs i =2S%.etoj b Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax iodetermined bymultiplying the account balance by the percent taxable. 5. Enter thetotal cd any debts and deductions claimed from Part 2. G. Thaamount taxable is determined by subtracting the debts and deductions from the amount subject to tax. ' . 7. En|erthe appropriate tax rate from Step 1based onyour relationship 1nthe decedent. If indicating a different tax rate,please state Official Use Only 0 AAF your relationship to the decedent: PA Department of Revenue 4. Amount Subject to Tax 4 $ 3 5. Debts and Deductions 5 - 4 8. Tax Due 8 Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Department of Revenue. Underpehu|(yofperju[y. |deo]anatha1thotoots|haverepodedabovnam1mo.00neu and complete Lothe best u/myknowledge and F • w i y o y�f t 5r o CL A_ cr tiZ IL z �