HomeMy WebLinkAbout05-18-15 e�R�� oF ��o:��o�e� ,..Es �,,.@�nnsyNania 1n"heritance Tax � .� pennsylvania
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�'���J�.�{�Y 13 ��j � �� TypeofAccount
�- � � Es�ate a� EDITH K KATZ � Security
'� �SEC Acc�
�li-�p�'�' ��ateofDeath03-31-2015 Stock
KATHRYN K A9ERMAN � � CounryCUMBERLAND Bonds
1112 ACRE DR CJ��" . �
CARLISLE PA 17013-4205
AME2IPRISE FINANCIAL 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.
RemN Payment and Forms to:
ACcountNo.4408
Oate Established REGISTER OF WILLS
Accoun� Balance $476,466A2 1COURTHOUSES�UARE
Percent Taxable X 100 CARLISLE PA t7013
Amount Subjec��o Tax $476.466A2
Tax Rate X 0.045
Poten�ial T� Due $p��qqp,gg NOTE': I�tax paymen�s are made wi�hin�hree mon�hs of Ihe
decedenPs date of death, deduct a 5 percent discount on the tax
With 5%Discount(Tax a 0.95) $ (see NOTP) due. Any inheri[ance tax due will become delinquent nine months
afterthe date ottleath.
PART St2P 1 : Please check the appropriate boxes below.
1
A �No tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who was
21 years old or younger at date of death.
Pmceed ro Sfep 2 on reverse. Do not check any other boxes and disregard fhe amounf
chown abeve ae Pofer.ba� Tax Cue.
g �The information is The above iniormation is correct, no deductions are being taken, and payment will besent
rorrect. wi�h my response.
Proceed to Sfep 2 on reverse. Oo not check any ofher boxes.
� �The tax rate is incorrec�. � 4.5% I am a lineal beneficiary(parent, child grandchild, e�c.)of�he deceased.
(Select corred tex rate at
right, and complete Part � �p� I am a sibling of the deceased.
3 on reverse.)
� 15% Allotherrela�ionships (including none).
p �Changes or deductions The information above is incorrect and/or tlebts and deductions were paid.
listed. Complefe Part 2 and part 3 as appropriate on the back ol this lorm.
E �Asset will be reported on The above-identified asset has been or will be reported and tan paid with the PA Inheri�ance Tax
inheritance[av form Retum filed by Ihe estare representative.
REV-1500. Proceed fo Step 2 on reverse. Do not check any othei boxes. �
Please sign and date the back oi ihe form when finished.
PApT Debts and Deductions
2
Allowable deb[s and deductions must meet bolh of�he following criteria:
A. The decedenl was legally responsible for payment,and the estate is insuflicient to pay the deductible items.
B. Vou paid the debis atter the death of ihe decedent and can fumish pmof of payment if requested by ihe department.
(Ii additional space is required, you may attach 8 1/2"x 1 Y sheets of paper.)
Date Paid Payee Description Amoun� Paid
Total En�er on Line 5 of Tax Calculation $
PART Tax Calculation
3 If you are making a correction to the establishment date(Line 7)account balance(Line 2),or percent taxable(Lne 3!,
please obtain a writlen correction irom the tinancial instilulion antl atlach it to lhis form.
L En�er the da�e�he accoun�was established or�itled as it existed a��he date of death.
2 Enter the�o�al balance of lhe accoun�including any interesl acemed a[ihe da�e o�dea�h.
3 Enterthe percen�age ofihe accountthatistaxable to you.
a. Firsl,de�ermine the percen�a9e owned by[he decedenl.
i. Accounts that are held"in trust for another or others were 100%owned by the decedent.
ii. Forjoint accounts established more than one year prior to the date of tlealh, the percentage taxable is 100%divided
by the total number of owners including Ihe decedenL (For example:2 owners=50%, 3 owners=3333%,4 owners
=25/,etc.)
b. Next,divide the decedenCs percentage owned by ihe number of survivin9 owners or beneficiaries.
4. The amount subject to tae is determined by multiplying the account balance by the percent taxable.
5. Enter�he tolal o�any debls and deductions claimed irom Part 2.
6. The amount taxable is determined by subiracting the de6ts and deductions irom ihe amount sublect to tax.
Z Enter[he appropriate lax rate irom Step 1 based on your relationship�o�he deceden�.
If indicating a diBeren�tax rale, please sla�e (�7613� �SC�fl�Y.0�411f
your relationship to the decedene pq�}gp3�trt�2�AtOf R@vBIAUB �
1. Date Established 1
2. Account Balance 2 $ PA��
3. PercentTaxable 7 X �
2
4. Amoun�Subjecl to Tax 4 $ (j � '
5. Debts and Deductions 5 - 4 � �
6. Amoun�Taxable C $ s
Z Tau Rate � X 7 '
8. Tax Due 8 $ g �
9. With 5% Discoun� (Tax x 95) 9 x � " �
StQp 2: Sign and date below. Retum TVJO completed and signed copies�o�he Register of Wills listed on the�mn�of this�orm,
along with a check for any payment you are making. Checks musl be made payable to"Register of Wills, AgenC' Do not send
payment directly[o the Depatlment of Revenue.
Under penalry of perjury, I declare[hat the facts I have reporled above are irue,correct and complete ro the best of my knowled9e and
belief.
Work
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Taupayer Si nature 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: 7-800-447-3020