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Home My WebLink About05-26-15 REV-1�62IXI11-961 caMMorvwEn�.n oF acr�Nsnvnwn EPAFTMENi OF PEVENVE BVFEAU OF IN�INDOHL TAXES OEPT.380fi01 Hnrrrriseunc.rn naeosoi pENNSY WANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020724 HALEY MARY K 1324 3RD STREET ENOLA, PA 17025-2390 ACN ASSESSMENT AMOUNT CONTROL NUMBER _ -- ---- 1a1e 15125831 � $9��z ESTATE INFORMATION: ssN: zoa-zs-s�65 FILE NUMBER: 2115-0577 � oECEOENT NnME: HEIKEL CATHERINE A I DATEOFPAVMENT: 05/26/2015 I POSTMARK DATE: 05/26/2015 I COUNTY: CUMBERLAND I DATE OFDEATH: O3/ZB/20�5 � � TOTAL AMOUNT PAID: $9��2 REMARKS: CHECK# 644 INITIALS: CJ sEA� RECENED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTEF OF WILLS euxenu or �xurv�ow� raxes Pennsylvania lnheri[anceTax - � - . Penr15�/LV8�118 �0 BOX 26Y601 DEPAFTMENTOFPEVENUE RNISBIING PP 1]IIB-0601 Information Notice And Taxpayer Response IS-057� r�C _ _ _ __, - - Fi�eNo.z, - �� .. , ... . . .' . ,- �. ACN15125831 � DATE OS-1&2015 �01� �a� zs �n z o0 Type of Account , �� Estate of CATHERWE A HEIKEL Savings � - � Checking � � � Date of Dea�h 03-26-2015 Tmst MARY K HALEY CL � �_ COUntyCUMBERLAND CErtifiCate 1324 3R0 ST ENOLA PA 17025-239D asEcu provided the department with the information below indicating that a[the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment antl Forms to: Accoun[No.2042697fi5 Date Establishetl OS1S7976 REGISTER OF WILLS Accoun� Balance $q54.74 1 COURTHOUSE SQUARE PerceniTaxable %50 CARLISLE PA 17013 Amaunt Subject to T� $22737 Tax Rate X 0.045 NOTE': If tax Dayments are made within three months of the Potential Tau Due $ 1023 decedenfs date of death,deduct a 5 percent discount on the lax Wi[h 5%Discount (Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine monihs atler the tlate of death. PART St2P 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of ihe deceased or I am ihe parent of a decedent who was 21 years old or younger at date of death. Proceed ro Sfep 2 on reverse. Do nof check any other 6oxes and disregard the amount shown above as Potential Tax Due. g �The informa�ion is The above in(orma�ion is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed ro Step 2 on reverse. Do not check any ofhei boxes. � �7he tax rate is incorrecL � 4.5% I am a lineal beneticiary(parent,child grendchild,etc.)of the deceased. (Select correct tax rate at right, and complete Pan � �p� I am a siblin9 of ihe deceased. 3 on reverse.) � 15% All other rela[ionships (including none). p �Changes or deductions The informa[ion above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back ol this lorm. E �Asset will 6e repotled on The above-identified asse�has been or will be reported and tae paid with the PA Inheritance Tax inheri�ance[aY form ReNm filed by�he esta�e representative. REV-1500. Proceed to Step 2 on�eveise. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable deb�s and deductions mus�meet both of(he following cri�eria: A. The deceden�was legally responsible for paymen�,and�he estale is insuHicient to pay ihe deductible items. B. You paid the debts after the death of the decedent and can Wrnish proot of payment if requested by the depariment. (I!additional space is required,you may attach 8 1/2"x 71"sheets of paper.) �ate Paitl Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If ycu are making a cor.ection to the establishment date(Line�)account balance(Line 2),or percent taxable(Line 3); please obtain a written correction imm the tinancial institu[ion and atlach it b this form. L Enter the date the account was established or titled as it existed at the date of death. 2 Enter the ro[al balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a Firsl,de�ermine the percentage ownetl by ihe decedent. i. Accounts ihat are held "in�msl for"another or others were 100%owned by lhe decedent. ii. For join�accounts established more than one year prior to the date of death,the percentage taxable is 700%divided by lhe total number of owners including[he decedenL (For example-2 owners= 5�%, 3 owners=33.33%, 4 owners =25%.e�c.) h. Nex�,divide Ihe decedenYs percen�age owned by the number o�surviving owners or beneficiaries. 4. The amount su6ject ro tax is determinetl by mWtiplying the account balance by the percent taxable. 5. En[er the total of any debts and deductions claimed from Part 2. 6. The amoun[�axahle is de�ermined by sub�racting lhe deb[s and deductions irom�he amount subject b tax. Z Enter the appropriate[ax rete irom S�ep 1 based on your relationship m Ihe decedent. If indicating a difleren�tax rate,please state Q((�jy��gg Qp�p-O qqF your rela�ionship to the decedenC pJ{pgj��(m011t qf pBVgnpg � 1. DateEstablished 1 S -IS'IF7� 2 Accountealance 2 S 45H. 7N PA� 3. Percent Taxable 3 X � � � �� 2 ��'` = za a. nmoumsubieccmrac a $ .�a"1• 3 3 ' �� 5. Debts and Deduclions 5 - $ fi. Amount Taxable 6 $ 1� 3 $ : Z Tax Rate 7 x � �`i 6 �� 8. Tav Due 8 $ �O .�3 7 � . $ ' _ ._ 9. With 5% Discount (Tax x .95� 9 X �,��-- . - � .StEP 2: Sign and date below. ReWrn TYJO wmpleted and signed copies to the Register of Wills listed on�he front of ihis form, along 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 the Department of Revenue. Under penalty of perjury, I tleclare lhat the facis I have reported above are true,correct and complete to ihe best of my knowletlge and belief. /� Work �� L. � V.c- Home 717 -(aY5��N? �/ r-aa-it 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: 1-800-447-3020 r.v 0 � � R[C:l��.--- - -r..,c CF r;�c ' ^ J� p w °0?S I�i�Y 2o S'�� ? 00 �r. � �, � oa�t�r c��a: = ._ �. � ,.,_ �, �i , �� i� ,� � f! t� � � n � � �:. � � � S (