HomeMy WebLinkAbout04-23-15 BUREAU OF INDIVIDUAL TAXES Pennsyfvania Inheritance Tax tm pennsyLvania
PO BOX 2BD601
HARRISBURG PA 17123-0601 Information Notice DEPARTMENT OF REVENUE
REV-1543 EX ft.r=nt-m
RECORDED OFFICE 6pd Taxpayer Response
FILE NO,21 — 6-LIS-7
REGISTER OF WILLS ACN 15112995
I I DATE 03-13-2015
?015 FIR 23 AF1 9 51
Type of Account
C L E R i OF Estate:of PATRICIA A LEIGHTON Savings
0 R P H A N'S' C T SSN Checking
Date of Death 02-07-2015 X. Trust '
MARY C LEIGWQUMBERI21 County CUMBERLAND Certificate
863 CENTRAL ST
FRAMIN9HAM MA 01701-4815
MEMBERS IST FCU provided the department with the information below indicatin.0 that at the death of the
above-named decadent you were a joint owner or beneficiary of the account identified.
Account No.19899 Remit Payment and Forms to:
Date Established 01-26-2015 REGISTER OF WILLS
Account Balance $38,003.74 1 COURTHOUSE SQUARE
Percent Taxable X 1.00 CARLISLE PA 17013
Amount Subject to Tax 138,003.74
Tax Rate X 0:045 .NOTE*: If tax.payments are made within three months of the
Potential Tax Due $1,710.17
With 5°/,Discount(Tax x 0,95) _$(see NOTE') decedent'sdate of death,deduct a 5 percentAiscount on the tax
due. Any inheritance tax due will'become delinquent nine months
after the date of death.
PART Step l:-please-.check-theA: ppirciodate boxes below.
A EJ No tax Js du&.' ia'ihespouse.of„-the deceased ori am the parent of a decedent who was
21 eaf5 did 61 yoUnge
r aft dale of death.
P6e 'Step
20.n reverse. Do not chedkany other boxes and disregard the amount
sticLym abjp,�e_as-Poter�itial Tax Dupe
The information is The abase'4fformafion 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 712% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships(including none).
D LJ 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 F-]Asset will be reported on The ab6ve-ideh.iified asset has been or will be reported and tax paid With the PA Inheritance Tax
inheritance fax form Return filed by the estate representative,
REV-1500. Proceed to Step 2 on reverse. bo not check any other boxes.
Please sign and date the back of the form When finished.
-
~ ~
PART
Debts and Deductions
Allowable debts and deductions must meet both of the 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 ofthe decedent and can furnish proof o|payment if requested bythe department.
(If additional space iarequired,you may attach 8112"x11^sheets ofpape .)
Data Paid Payee Description Amount Paid
Total(Enter on Une 5 of Tax Calculation.) $
PART
' 8X CalculationCalculation�--�-� If
Taxm,making econe�n�noo�he�ou��|imhme,it date(Line 1)account b |anoe(Lineu),orpercemttaxabie(Line3)'
p|diioeobtm!6�hvxntteno6nection from the finanvia0lh!g1tc¢nnand mtiadhkto tbisYmhn
1. Enter the date theaccount was a�a6|i»hedorhUodatit e�obad/�1hed�eofdo�h.
2. Enter the total ba|unoewfthe account including any interest accrued authe date nfdeath.
3. Enter the percentage ofthe account,that istaxable toyou.
o. First,determine the percentage owned bythe decedent.
i. Aucoumm8`s¢.a,eheld"in trust for"another,,others were 1U0%owned bythe decedent.
ii. For joint accounts established more than one year prior to the date of death,the percentagetaxable is1
bythe total number ofowners including the decedent. (For example:2owners=50%.3owners~3333%;4owners
~c5Y6.etc.)
b. Next,divide the decedent'spercentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total o(any debts and deductions claimed from Part 2. '
O The amount taxable iadetermined bysubtracting the debts and deductions from the amount subject totax.
7� Enter the appropriate tax rate from Step 1 based onyour relationship!othe decedent.
your relatibnsh�p to the decedent'
2. Account Balance $
ggk RIP
as,KaLpg�
3. Percent Taxable 3 X
4. Amount Subject to Tax B,
5. Debts -and Deductions 5 Aw-amu
6. Amount Taxable -6 $ 0-
----' -- ldkRate-- -- ---`--T-�-- -- -----
O Tax.Due n
Step 2: Sign and date below. Return completed and signed copies to the Register nfWills listed onthe front ofthis form,
along wbhacheck for any payment you are making. Checks must bemade payable to"Register ofWills,Agen[ Do not send
t directly to the DeparLnne t of Revenue.
I d he facts I have reported above are true,correct and complete to the best of my knowledge Under penalty of perjury,,,�e, �that t
d