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Home My WebLink About05-04-15 (2) commorvwv.vrv or aervrvsv�vnrvin qEV-t t6J. Ex�t t 861 DEGFPTMENT OF qEVE\OE AU OF IN�N011PL TA%ES T )00601 HPPPISBLP6,PA1J129d601 PENNSYLVANIA RECEIVED FROM: INHEFITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020612 COLE JUDITH K 600 CARBON AVENUE HARRISBUflG, PA 1 71 1 1-4525 ACN ASSESSMENT AMOUNT CONTROL NUMBER 15118437 � 586.21 ESTATE INFORMATION: SSN: FILE NUMBER: 2115-0404 � DECEOENTNnnne MARVIN ELIZABETH M � DATEOFPAYMENT: 05/O4/2O1S I POSTMAFK DATE: 05/01/2015 I COUnl7v: CUMBERLAND � DATEOPDEATH: 03/15/2015 TOTAL AMOUNT PAID: 586.21 REMARKS: RECEIPT TO ATTY CHECKti4036 INITIALS: CJ sen� RECENED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAVER °°"�^° °` ,"°'°�°'"� �"'Es Penns Ivania lnheritance Tax � Pennsylvania PO BO% 200601 Y HARRISBVRG PA ll�ae-ozol �f1fOfRldllOfl N�(ICQ DEPAPTMENTOFpEVENUE And Taxpayer Response "'-",�°."P``•" �•, FlLE NO.21-I'�'O`}O�f ACN 15ll8437 DATE 04-06-2015 Type of Account Esta�e of ELIZABETH M MARVIN �Savings Checking Date of Death 03-15-2075 Tmst OONALO L COLE CountyCUMBERLAND X Certificate 600 CARBON AVE HARRISBURG PA 17111-4525 n � � C o `r' , � � � � n a �� -� � ..-� :� ' c� . i ,'.-� - i . . . — S . ..., � - . ' .�._.... �q _ _. . _.._ I" � � = <� N .— Cl vsEcu provided the department with the information below indicating that at the death of th� �CO � above-named decedent you we�e a joint owner or beneficiary of the account identitied. Remit Payment antl Forms to: Accoun�No. 191183&50 Date Established 02-09-2004 REGISTER OF WILLS Account Balance $24,201.00 1 COURTHOUSE SOUARE PercenlTaxable X 8.333 CARLISLE PA 77013 Amount Subject to T� $2,016.67 Tax Ra�e X 0.045 NOTE": If tax payments are made wi�hin�hree months of Ihe Potential Tvc Due $9�75 decedenYs date of death, deduct a 5 percent tliscount on�he tax With 5%Discoun� (Tax x 0.95) $(see NOTE') .�� due. Any inheritance�ax due will become delinquent nine months after ihe 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. Proceetl to Step 2 on reverse. Do nof check any ofher boxes and disregartl the amount shown above as PotentialTax Due. g �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. p �The tax rete is incorrect � 4.5% I am a lineal beneticiary(parent, child, grandchild, e[c.)of the deceased. (Select correct�ax ra�e at right, and complete Part � �p� I am a sibling of the deceased. 3 on reverse.) � 75% Allotherrela�ionships (indudingnone). p �Changes or deductions The information above is incorrect and/or debis and deductions were paid. listed. Complete Part 2 antl part 3 as appropnafe on the back ol this lorm. E �Asset will be repohed on The above-identifietl asset has been or will be reported and tax paid with ihe PA Inheritance Tax inheritance tax form Retum filed by the estate representative. REV-1500. Proceed ro Step 2 on reverse. Do not check any ofherboxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable deb[s and deductions must meet 6oth of[he following criteria: A. The decedent was legally responsible for payment, and ihe esta[e is insufficient to pay the deductible items. B. Vou paid ihe debts aiter the death of the decedent and can fumish proof of payment if requested by ihe department. Qf adtlitional space is required, you may atlach 8 1/2"x 11"sheets of paper.) Dale Paid Payee Description Amounl Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment tlate(Line 1)account balance(Line 2),or percent taxabie(Line 3), Dlease obWin a written correction from the tinancial ins�itution and atlach i�to�his form. 1. Enter the tlate the account was established or titled as it existed at the date of death. 2 Enter�he total balance of the accoun�includin9 any interest accmed a�the da�e of death. 3. Enter�he percen�age of�he account�ha�is taxable�o you. a. First. determine the percenta9e owned by ihe decedent. i. Acwunts ihat are held"in imsl for"another or others were 100%owned by ihe decedent. ii. For joint accounis established more[han one year prior to Ihe da�e of death,�he percentage��able is 100%divided by lhe to�al number of owners including the decedenL (For example:2 owners=50%, 3 owners=33.33%, 4 owners =25%,etc J b. Ne�,. divitle�he decedenPs percen�age owned by the number of surviving owners or beneficiaries. 4. The amount subject b tac is de�ermined by multiplying the account balance by the percent tacable. 5. Enter the�o[al of any debts and deductions claimed trom Part 2. 6. The amount taxable is determined by subtracting the debts and deductions irom the amouM subject�o tax. 7. Enter the appropriate tac rete irom Step 1 based on your relationship to the decedent. If indicating a diReren�tax rate, please state Q�C��(JSQ.�1�y��ppF � your relationship to lhe decedent: '�"�'" ` � PA DeparttTlanY af:A2venu@ � ;s.: 1. Date Established i - „�'�"` r.�.';"�` ` 2. Account Balance 2 $ Pp'D�. � Fp y. 3. Percen�Taxable 3 X 2 "�" � an 4. Amoun�Subject to Tax 4 $ 3 5. Debts and Detluctions 5 - 4 6. AmountTaxable 6 $ 5 ,,,.a� � Z Tax Rate 7 X 6 . �= .:=�.-;�� 8. Tax Due 8 $ $ - 9. With 5% Discount(Tax x .95) 9 X � � - St@p 2: Sign and date below. Return TWO completed and signed copies to ihe Register of Wills listed on ihe iront of this form, along wi[h a check for any payment you are making. Checks must be made payahle to"Register of Wllls, Agent" Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare ihat the facts I have repotled above are true,correct and complete to�he best of my knowledge and belief. G� � p wo�k N jA °�-� �-m't-a��. �l C'a-2sz--- Home ��l - �n�- � �J� � �- �- {5 Taxpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-4473020 _ __ 0 A � q � O A � c c t� RECGR��-� � � r,�_CE OF � o � REGI��-- , .._ , . _ a y i PI112 53 � a 2�]5 �1flY `1 � ; '` a c�:_ . °- �;^ " ORPHA•i:J' ^ , . ,- CUMC:�.'1 _ ; r •'� � �.. � t�! u �:� ra c:� �,, +AI � _ ` � � � T F+ � Z � _ � D v� — � � C - �` . � '� � �; - �� , - � f - � � ; _ � r N _ O - Yl+ �� }�.� = � �"��f �e��;� •�� >