HomeMy WebLinkAbout05-15-15 (2) BUREAU OF INDIVIDUAL TAXESPenns Ivania Inheritance Tax °� pennsytvdnld
PO BOX 280601 y
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response -- REV-1543 Ex -EXE` (08-12)
RECOR ED OFFICE FILE No.2115-0068
RE C .i U I ,,!I L L ACN 15119073
DATE 04-08-2015
?01S MY 15 PM 1 09
Type of Account
CLEF.'` CF Estate of LOIS M SIMS Savings
ORPH Aki'i�5 E 't;i SSN X Checking
Date of Death 01-05-2015 Trust
CAROL A S I M6 U M s r"` 4 `'` County CUMBERLAND
Certificate
C 0 CAROL SIMS
13876 SWISS LN
TRUCKEE CA 96161-7117
PNC BANK NA 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.5140219701 Remit Payment and Forms to:
Date Established 11-30-2010 REGISTER OF WILLS
Account Balance $19,930.94 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $9,965.47
Tax Rate X 0.045
Potential Tax Due $ 0.04 5 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 F�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
_ sho..n 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 F�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 ❑ 12% 1 am a sibling of the deceased.
3 on reverse.)
15% All other relationships (including none).
D F]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. A�,�
BUREAU INDIVIDUAL TAXES
PO 28PennsylvaniaInheritance BOX 280601 InheritanTax � '� pE'11nsytvani 1
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
`-' REV-1543 EX D-EXEC (08-12)
And Taxpayer Response FILE N0.2115-0068
RCR�L OFFICE OF ACN 15119074
R Ev►S T r` (;; t'1 I ( DATE 04-08-2015
?015 nfiv Pm 1 C9 Type of Account
�F( Estate of LOIS M SIMS Savings
P11 r ., SSN Checking
0 R( ((�, ,' Y„ ; 1_ Date of Death 01-05-2015 Trust
CAROL AWH* { �' P County CUMBERLAND Certificate
C 0 CAROL SIMS
13876 SWISS LN
TRUCKEE CA 96161-7117
PNC BANK NA 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.5005798755 Remit Payment and Forms to:
Date Established 11-29-2010 REGISTER OF WILLS
Account Balance $37,312.42 1 COURTHOUSE SQUARE
Percent Taxable X 50
CARLISLE PA 17013
Amount Subject to Tax $ 18,656.21
Tax Rate X 0.045
Potential Tax Due $ 0.0 53 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
AF-]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 0The 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 F�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 F—]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. \\n�
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