HomeMy WebLinkAbout04-24-15 (2) BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax • : pennsylvania
PO BOX 280601 DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0601 Information Notice
REV-1543 E%DocE%EL (08-12)
And Taxpayer Response FILE NO.21 S 3�'s"
EGOR ED OFFICE OF ACN 15120130
W ,�% R }P }r' i DATE 04-14-2015
?QIS PPR 2 9 PM 12 10 Type of Account
EstaC L OF SSNte of MILD
3D A JEZ SavinChecking
O R P H A N S' C;;Date of Death 03-22-2015 Trust
LINDA A SMELTZ G(j � nt r,,' �,County CUMBERLAND Certificate
4 WHEATLAND DR ;
MECHANICSBURG PA 17050-1600
MEMBERS 1ST FCU 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.12629 Remit Payment and Forms to:
Date Established 10-20-1971 REGISTER OF WILLS
Account Balance $4,000.23 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $2,000.12
Tax Rate X 0.045
Potential Tax Due $90.01 NOTE': 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 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. F_� 4.5% 1 am a lineal beneficiary(parent,child,grandchild, etc.)of the deceased.
(Select correct tax rate at
right,and complete Part F_� 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.
Deductions
Debts an= ^°"=W~OQns
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 isrequired,you may attach 81/2^x11^sheets ofpaper.)
Date Paid Payee Description Amount Paid
Total,(Enter on Line 5 of Tax Calculation) , $
PART Calculation
���
. =�
If you are making a correction tothe establishment date account balance(Line 2),orpercent 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 nf the account that imtaxable 0oyou.
a. First,determine the percentage owned bythe decedent.
i.. Accounts that are held"intrust for"another or others were 100%owned by the decedent.
ii. For established more than one year prior 0mthe date ofdeath,the percentage taxable ialOU%divided
bythe total number ofowners including the decedent. (For example:2owners=5O%.3owners=33.38%.4owners
~25%.eto.)
b. Next,divide the decedent's percentage 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 of any debts and deductions claimed from Part 2.
8. The emouhttaxable iodetenn\nedbysubtracting the debts,and deductions from the amount subject 1otax.
7. Enter the appropriate tax rate from Step 1based onyour relationship Vothe decedent. `
If indicating a different tax rate,please state Official Use Only 0 AAF
your relationship to the decedent:
PA Department of Revenue i
2. Account Balance 2 $ PAD
4. Amount Subject to Tax 4 $ 3
5. Debts and Deductions 5 4
Step 2: sign and date below. Return TWO completed and signed copies to the Register cfWills listed onthe front ofthis form,
along with acheck for any paymentyoumvumoking. Checks must bemade payable to"Register ofWills,Agent.^ Donot send
payment directly tothe Department ofRevenue.
Under penalty cfperjury, |declare that the facts|have reported above are true,correct and complete tuthe best ofmyknowledge and
belief.
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