HomeMy WebLinkAbout04-20-15 �i� pennsylvania
,�a�.� o. ,�o���o�� ,<.F� Pennsylvania lnherilance Tax oEppq,MEH,oF aevENue
Po aa. �eoso� Information Notice �� ,,, ,,,,,,o,�,., o..�,.
NPRRISBORG PP 1]130-�601
And Taxparyer Response Fi�E NO.zi � i�-��`I(,��C
ECO^D'_�:� C'.r 'I�..E CP qcNisiziias
EG�S'.:�_ - ,',��_�S onTeoa-zo-2oie
���5 P�PR 22 �� 12 �'� TypeofAcCaunt
� �i:Estateo(PAULMURTOFFF Savings
� -SSN80340-3012 �Checking
�RP ' �DaIB of Death 03-10-2015 Trust
.r �Counry CUMBERLAND Certificate
HELEN M RIEKER CU���'�--�� � � �
560 STONV BATTERV RD
LANOISVILLE PA ll538-1406
er+c eANK NA provided the department with the information below indicating that at the dea[h ot the
above-named decedent you were a joint owner or beneficiary of the account identified.
pemit Paymeot and Forms to:
Account No.5114434213 REGISTER OF WILLS
Date Established 03-07-2014 1 COUfiTHOUSE S�UARE
AccouniBalance 54,52z.�6 CAFLISLE PA 170�3
Percent Taxable X 50
Amount Subject ro Taz $2,261.08
Tax Rate X 0.045 NOTE''. If tax payments are made within three months of the
Potential T� Due $ 10175 decedenfs date of death,deduct a 5 percent discount on the tax
With 5%Discoun[(Tax x 0.95) $(see NOTE') afterthe date of deathtax due will bewme delinquent nine months
Pp'RT S{eP 1 : Please check the appropriate boxes below.
1
n ❑No tax is due. I am the spouse of lhe deceased or I am the parent of a decedent who was
21 years old or younger at date ot death.
Proceed to Step 2 on reverse. Do nof check any ofher boxes and disreqaN the amount
shown above as Potential Tax Oue.
g �7he information is The above information is wrrect, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do no[check any other boxes.
� �The tax rate is inconect.
� 4.5% I am a lineal beneficiary (parent,child,9randchild,etc.) of the deceased.
rght anticompleterPartt �
�p/ I am a sibling of the deceased.
3 on reverse.)
� 15% All o�her relationships(including none).
p �Changes or deductions The informalion above is incorrect and/or debts and deductions were paid.
lisled. Complete Part 2 and part 3 as appropriate on the back o�this form.
E ❑Asset will be reporled on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritancetaxform Fleturn����dto�Step2on�eve�se.��Donofcheckanyotherbozes.
REV-1500.
Please sign and date the back of the form when finished. �
PART
2 Debts and Deductions
Allowable debts and deductions must meet both of ihe�ollowing criteria:
A. The decedent was legally responsible for payment,and ihe estate is insufficient to pay the deductible items.
B. Vou paid the debts after the death of the tlecetlent and can furnish proof o�payment if requested by the department.
(If additional space is required,you may atlach 8 1/2"x 11"sheets of paper.)
Date Paid Payee Descrip�ion
Amoun� Paid
3 -� i -
Total Enter on Line 5 of Tax Calculation $
PApT Tax Calculation
3 If ycu are making a corractiort to the esWblishment Aate;Line 7)accounS balance Line 2 ,or
pleau obtain a writlen correctlon irom ihe financial institution antl atlach it to thia form.) �rcent taxablelLine 3),
1. Enter the tlate the account was established or titletl as it existetl at ihe tlate of death.
2 Enter the btal balance ol Ihe accoun�including any interest accrued at the date of death.
3. Enter the percentage of the account that is tauable to you.
a. First,determine the percentage owned by the tlecedent.
i. Accounts ihat are held'in tmst for"another or others were 100%owned by the decedent.
ii. For joint accounts establishetl more than one year prior to the date of death,ihe percentage taeable is 100%divided
by the b�al number of owners including the decedenL (Por example:2 owners=50%, 3 owners=33.33%, 4 owners
=25/,etc.)
b. Nex�, divide the decedenCs percentage owned by�he number of sunivinq owners or beneficiaries.
4. The amount subject to tae is determined by multiplying the account balance by ihe percent taxahle.
5. Enter ihe rotal of any debts and tleductions claimed from Part 2.
6. The amount taxable is determined by subtracting the de6ts and detluctions from the amount subject to tax.
Z Enter the appropriate taz rate from S[ep 1 based on your relationship to the tlecetlent.
If indicating a ditterent tax rate,please state :
your relationship to�he decedent +�',�y, `i `p�IQ�(�� [�'�-§" "�}�_, _; �
1. Date Estahlished � � +# �/����laj� �'".,.t,;�� �'��..
2. Accoun[Balance � k� '�+"`x t � ���z ¢ � ' �4 �
3. PercentTaxable 2 $ ���� "��""� "" � �
3 x +� ��... � �.,:
4. AmountSublect�oTax q $ ��, ¢�� �� '° ,,;y�r
+ z �
5. Debts antl Deductions 5 - �S ` � % �`#'��" r�: � G r w.,�, i' .;e� �,
6. AmountTaxable g $ �u�' �� "`::�• � ;�" � " ,,,..
7. T� Rate 7 % IS " w �4 - � �,
8. Tar Due g $ �aT rd�#'� 't= t'� � ei »r'rt � i �, r �, ."
9. With 5 o Discoun�(Tax x .95) 9 X ��:-�'��"'�� �`•�'�' � �`` �.�9 ��' � „y ��
t �
SteP 2, Sign antl date below. Retum TV✓O completed and signed copies to the Register of Wills listed on the front of ihis form,
alonq with a check for any payment you are making. Checks must be made payable to"Register of Wills,AgenC Do not send
payment directly to ihe Department of qevenue.
Under penalry o�perjury, I declare that ihe facts I have reported above are hue, correct antl wmplete to the best of my knowledge and
belief.
, ' l� J� �� Work
�� 5-- 7 � Home 7/7 �9.2 /t!-/9 !-� !2n a0/S
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-g327, SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020
� .'__._ r . . _ r�'-p.:��. . . . . . . ... . . .
. _.— , .____. ._.
HoIIinger Funeral Home &Crematory, Inc.
. � Eric L.Hollinger.Supelvisor �
� March 16,2015 � � . � � � . � �
Helen M.�Reiker � � � _ . � � �
� � 5605tony.BatteryRoad . �� . � . . �. �-
� Landirville.PA 17535 . � . � � . �. .. � . .
� � The Funeral5ervice for Paul E.Murtorff: � � �-
�� We sincerely appreciate the conFdenceynu haveA�aced in us.and�will conTfnuexo assist you in every
.� � � waywe:can. Please-feelfreeto.contac[usifyouhave�anyquestionsinregardtothisstatement.
� � THEFOLLOWINGISAN�I7EMIZEDSTATEMENTOFTHESEftVICES, FACILITIES,_AUTOM,OTIVE.EQUIPMENT, �. . .. �
ANDMERCHANDISETHATVOU SELECTED WHEN MAKINGTHE FUNERALARRANGEMENTS�. � .
. ProfesvonalService � . � . . . . . . . . �$5150.00 . � � .
� Tratlitional�Package:: . . . . . ..
� . . . Merchandise . .. � � � . �� � . � . 2995.00 .
. .Casket-18�Gauge Brushed � . � � �95� � � �
� . Vault—Sentinel : . . � � . � . . -
� Memonal Package Blue � - � � . � � -
- � � Register Book,Memorial Folders;_ . N/c - �..
: Acknowledgement Cards,800kmarks. ' . : . . �
�- ATTHETIMEFUNE(1ALARRANGEMENTSWEREMADE,WEADVANCEDtERTA1NPAYMENTS'TOOTHERS � � .
� � �ASANACCOMMODATION. TMEPOLLOWINGISANACCOUNTINGEORTHOSECHARGES.� . . � � . .
. . Cash Advances . . . . � � 900.00 . � . . ..
GraveDpening � . . .
...:Gemetery.�quiPment . � �;� ..
� - �� VauRServiceChargefor9unday � - �1�'� . � � �� .
- � � Certified Copies of Death Certificate(6@$6) � � . 36.00 . . � � �
� � . .. .. . � . � . . _ 125.00 �. �
. . . C10rgy . � � . . . �_ .. . 212.00 : . .
Flowers-PamilySprey-Red;White,BahyBreath � 259.91. � � �
Newspape[:Notires—Sentinel � � � � . - Zq930��� �
. . . . . .. . Patfiot . . . . . ��. N/� .
� . � �En�ving �. . � . � � . . _ . ..
- .� . . � . . $12@2.21 �
. - Total Charges . . � . . . .. �
Hom�sxeaae.s slielzois � 3 a1'3-�O l5
. Balanrn Due - . . . . . . . . . . �'�-���� '�'T�
� SOINORTftBALTItr10REAVENIIE ' MOUNTHOLLYSPRWGS.PENNSYL9M1IAt�o65a (4�v)486-s433 • FAX(��9)'486-ss�5 � -.
. . . . ' wwm.holtlngerfuneraihome.com . . �
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Standard Checking Statement
so.m.P..�,a oaioenots ro oaroeizo�s
�For llhour information,sign on to PNC Bank Online Banking MELEN M RIEKEfl
on pnc.com. P�imary aaount number:51-1<43-4213
e4row�namber:51-14494219-con�inned Page 2 ot 3
Balancs Summary
e�innmo oaw:ns ana cn.crz a�e omer enm�y
Ealance aM1eraEaltions aeEunlons �alance
4.52Y.1fi .00 4,51Y.16 ./N1
A�2nqe mon��ly C�aryes
esizn« ana�.e:
Y,907.79 .�
Transaction Summary
C�eckspolE/ CM1xkCaNP05 C�![kCaN/BankwM
wltM1Erdwals siyneE�nnudlom POS PIN hansactlonz
1 0 1
TMaI ATM PNC Bank Ol�e�Bank
Iranssdions AiMlonsactloni ATM�rznaHlons
0 0 �>
Acnvlly Defail
Chedc� and SubaMuN Ch�cka
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�mm. nmoum w�e umc..
1076 4,48Y.56 os/Y6 oassasesY
There'slchecklis[eEtotaling $�AB3S8.
Banlung/Ch�ck Card �thdrawals and Purchas�a
wta nmoum oeuriqion TherewasiCheckCard/9ankcardPoNP05
08/11 3'3.60 POSPurchaeeWeisMvkelswla�saslerPA pumhasetotalingE39.e0.
Daily Balanaa Defail
wm eaian« oaie eaianc. oa�e eaiance
OS/O6 4,52Y.1C. 03/ll 4,4HY.56 OS/P6 .�
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Standard Checldng Statement � PNCBANK
YNC Bank
Primary axourrt number.514443-0213
Page 1 of 3
ForlMpxlod03/OB/3076b0A/OB/3075 Numharofenclosures:0
OOf a9] For 24hour banpng,and hansaRion or
� HELEN M RIEKER �intarestrateinformation,signonto
560 STONV BATTERV RO PNCBankOnline9ankingatpnacrom.
LANDISYILIE Pp 17538-1408 'a Forcustomerservicewlll-888-PNC-BANK
Monday-FriAay�.]AM-10 PM ET
Saturday&SunEay: 8 AM-5 PM ET
Para servicio an espaRol, 1-e66-HOLA-PNC
Morinpi Pleasewntac[usa[1-898-PNC-9ANK
�Writeb:Cus[omerService
Po Hox 609
Yitlsourgb rA 15Y30-§73e
�Visk us a[PNC.com
� T��terminaC i-B00-5314fi48
Fcr M1cumq impa'v�nl�lim�s only
IMPOR'1'ANT ACCOUNT INFORMA770N
'1'he inFormatio¢below ameuds certein informetiun in oac"Consamer Schedule of Service Chacges and Fees"("Schedule'�.All othec
infortnatioo iu our Schedule continues W apply w yoar accounL Please read this infortna[ion and re[aiv i�with your records.
N:Rcctive May 10,2015
7'he A1'M'Iransection Fee a[Noe-PNC Uank A1'M'sin the Uniled States,Canada,Paerto ltico and Ihe U.S.Virgin Islands will be 53.00
each.
'1'he Domestic Outgaing Wire fee will be 530.00 each.
EHective June 1,2015
American Express'fravelers Cheu ues and GiR Chepues will no Ion¢er be available for ourchase
We havc toole tu help you bank when and whcre you want.
Ge[idY eaesa w you�t tiC lianic accomt,infurmanon aud eervicze,by uxing i NCblfi Nis,ivlobiie 13avking,`vniiue Uenkiug auu mum.Go
to pnc.coMalwaysopeu Fur more infurtnation.
Standard Checlung Account Summary Helen M Riekar
A000unt numMr. 51-1443-4213
Mordnft Proeootbn has not been established for ihis account.
Please contac[us if you would like to sat up this service.
Ovordnft Govorag�-Your account is currentlyOpte�l�.
Voa or your joint owner may revoke your opo-in or op6out choice at any time.
To laern rtrore�bou[PNL Wertl�eX SONtiom viaR un anlirw a�pnc.compveMnttnolulione.
Cell 1-W]-5W3805,viek eny bnncb,or Sign on lo FNC Online Benking,mJ xlec[�M1e'Mardntt
Solu[bm9ink untler[�a qcmmt Services aec[ion[o menege both yourWerdnk Coverege entl Overdmk
Pm[eRioneettinge.
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