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HomeMy WebLinkAbout04-23-15 COMM�MNFALTH OF PENNSYLV4NIA REV-1162 EXI�' S'o. ,-enarr�eN�or Aevervue UPEUU OF IN�NIDUK TP%FS 1APi 39 OEO� xaisoene.v<n�zensm pENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020559 POPLASKI HOLLY A 12 MORARI DRIVE DILLSBURG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER --- — -- 15503154 � 5100.75 ESTATE INFORMATION: ssr�: FILE NUMBER: 21 7 5-0223 � DECEDENT NAME: BAHN ROBERT E I DATEOFPAYMENT: 04/23/2015 I POSTMARK DATE: O4/Z1/ZO15 � couNrv: CUMBERLAND I DATEOFDEATH: 02/14/2015 I � TOTAL AMOUNT PAID: 5100.75 REMARKS: CHECK# 885 INITIALS: CJ sEq� RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS FEGISTER OF WILLS a�a�� oF :Ho���ow� *.xEs Pennsylvania lnheritance Tax �� ��� PennS�/LV8�118 ro eox zeoco� �� � oecaarnervroraevervue xnearseoas w �nae-oso� Information Notice � - And Taxpayer Response "�""• "'"�"""•"' Fi�E ��o.zi is-ozz3 ncv ,ssoai sa R ,,.,.-� .� DATE04-20-2015 f����S'..._. ,�- '�il �S _ _ Type of Accoun� '0?$ PPR 23 �?,I 1$s�or aoaeaT E snHN �se����ry X SECAcct �i �.� . - Date of Death 02442C15 Srock HOLLY A POPLASKI pRP�{ � .,�J,�� ��'.' CountyCUMBERLAND Bonds 12 MORARI DR . �. OILLSBORG PA 17019-1555 ��fh!^;.?' ! '� JOHN HANCOCK ir+v 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. Remit Payment and Forms to: AccountNo.2040266 Date Established REGISTER OF WILLS AccountBalance $11,783.55 1 WURTHOUSES�UARE Percent Taxable X 20 CARLISLE PA 17013 Amount Subject to T� $2,356.71 Tax Ra�e X 0.045 NOTP: If tax paymen�s are made within three mon�hs of Ihe Potential T� Due $106A5 decedenPs date of death,deduct a 5 percent discount on the tax With 5%Discoun�(Tax x 095) $(see NOTE') �(7(�.'7 5 due. Any inheri[ance�ax due will berome delinquent nine mon�hs afterthe date ofdeath. PART St2P 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 nof check any ofher boxes and disregard the amount �ho�.vn above ac oofentiel ,T.;v Due_ g �The information is The above informa�ion is wrrect, no deduclions are being taken,and payment will be sene correc�. with my respanse. Proceed to Step 2 on reverse. Do no(check any ofher 6oxes. p �The tax rale is incorrecL � 4.5% I am a lineal beneficiary(parent child. grandchild, etc.)of Ihe deceased. (Select correct tax rate at right,and complete Part � �p/ I am a sibling of ihe deceased. 3 on reverse.) � 15% All other rela[ianships(including none). p �Changes or deductions The informa�ion above is incorred and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropnate on the back o/this lorm. E �Asset will be reported on The above-identified asse[has been or will be reported and t� paid with the PA Inheritance Tax inheritance tax form Retum filed by the esta�e representative. REV-1500. Proreed to Sfep 2 on reverse. Do not check any other boxes. Please sign and date the back oi the form when finished. PART Debts and Deductions 2 Allowahle deb�s and deductions must mee�both of[he following cri�eria: A. The decedent was legalty responsible for payment,and the estate is insufficien�to pay[he deductible items. B. Vou paid ihe debts after the death of ihe deceden[and can furnish proof of payment if requested by ihe depariment. Qt additional space is required, you may at�ach 81/2"x 11"shee�s of paper.) Da�e Paid Payee Description Amounl Paid To�al (Enler on Line 5 0�Tax Calcula[ion $ P'4RT Tax Calculation 3 If ou are makin a correc[ion to Ihe establishment date Line 1 account balance Line 2 , or y g ( ) ( ) percenttaxable(Line 3), please obtain a written correction iram ihe tinancial institution and attach i[to ihis form. L Enter the date ihe account was estahlished or titled as it existed at the date of death. 2 Enterthetotalbalance ofthe accountincluding anyinterestaccrued atthe date ofdeath. 3. En�er the percentage of�he account iha�is laxable�o you. a Firs�,de�ermine the percentage ownetl by�he decedent. '. Accounts�hat are heltl"in[mst for"another or others were�00%owned by ihe decedent. ii. For joint accounts established more ihan one year prior to�he tlate of death. ihe percentage taxable is 100%divided by Ihe total number of owners induding the decedent (For example:2 owners =50%, 3 owners=33.33%,4 owners =25/, etc.) b. Next, divide ihe decedenPs percentage owned by�he number of surviving owners or beneficiaries. 4. The amount subject ro tax is determined by multiplying ihe account balance by ihe percen[taxable. 5. En�er the total o�any debts and deductions claimetl Gom Pah 2. 6. The amoun�taxable is determined by sub�racting Ihe debts and deductions from the amounl subject to tax. 7. Enter ihe appropriate tax rate irom Step 1 based on your relationship to ihe decedent. If indicatin9 a diHerent tax ra�e,please state . � (��y� (!�y��ly Q�� your relationship ro ihe decedent pA Department ot�ReYenue :� 1. Date Establishetl 1 r.:,, , 2. Account 8alance 2 $ P���� 3. PercentTaxable 3 x 2 � 4. Amount Subjec�to Tax 4 $ 3 . S Debts and Deductions 5 - Q 6. Amoun[Taxable 6 S 5 7. Ta. Rate � X 6 8. Tav Due 8 $ � 8 9. WI�h 5%Dlscount(Tax x .95) 9 X �OD •��j . .St@P 2: Sign and date below. Retum 7W0 completed and signed copies to the Regis[er oi 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,AgenC' Do no�send payment directly ta the Departmen[of Revenue. Under penalry of perjury, I declare Iha�[he facts I have reported above are(rue,correct and complete to the best of my knowledge and belief. �� �� � �� " �� Work -Ill- 7N1- 1�144 �'%�1 �� ��L�/Lc-c� Home �1r7-�#3'�- ioqy `��a'U /5 Taxpayer ignature 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: i-800-447-3020 ,.. _ A--_�. 0 � ? � �� ,zo Y�_ ,A , - —_ � -OL -1 r � 0 W � W ` W W N N \ T- � � � r~ � D �. �; ! _ � � � _ � a h ? \ �' . 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