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Home My WebLink About06-01-15 coMMonw=_n�.N or vervrvsv�vnvia AEv-ns2 exn t ss1 oeannrMcn�.or aevcr��e rvioun�rn.es DEPiQp8060No HqPPISpVFG.PA 1I48-O601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIALRECEIPT NO. CD 020756 GAFDNER RUTH M 7 WEXFORD COURT CARLISLE, PA 17015 ACN ASSESSMENT AMOUNT CONTROL NUMBER 15124714 � S53.39 ESTATE INFORMATION: SSN: � FILE NUMBER: 2'I15-O591 I oeCeoervT NAME: MILLER PEGGY A � DATEOFPAYMENT: O6/O1/2015 � POSTMARK DATE: 05/26/2015 � couN7v: CUMBERLAND � DATE OF DEATH: 03/02/2015 � TOTAL AMOUNT PAID: 553.39 REMARKS: CHECK# 1474 INITIALS: CJ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS FEGISTER OF WILLS euxEau oF �umvioua� rnxes Pennsylvania lnheritance Tax �j �� PennSy�Vdllld ro enx zaoso� � � oecnArnervroFaevervue „.aw�:,�a� Pa „��a-aso� Information Notice ,�� , And Taxpayer Response �� [GOt=,_. . _ Fi�eNo.zi -�� ncti isi2a�iar � m r, o� � - DATiE OS-O6-20 "' �' - � c> ��5 ��N 1 �� 1� .�j� �� ' P�eofAccdunt . Estale of PEGGY A MILLEA' Savings �" '� Checking �i ' � �� ' � bate of Dealh 03-02-20�5 . � � . Tmst RUTH M GARUNER �(Jt1 CountyCUMBERLAND j � Cetlifica�e 7 WE%FORO CT � � p� ' CARLISLE PA 77015-7612 ' '� � SUSOUEXANNA BANK provided the department with the information below indicating that at ihe death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.251524755 Date Eslablished 06-15-2006 REGISTER OF WILLS Account Balance $ 1,67fi.46 1 COURTHOUSE S�UARE CARLISLE PA 17013 Percent Taxa6le X 16.667 Amount Subject to Tax $279.42 Tax Rate X 0.150 Potential T� Due g q�,g� NOTP: If tax payments are made within three monihs of the decedent's date of death,deduct a 5 percent discount on ihe tax With 5%Diswunl(Tax x 0.95) $(see NOTE') due. Any inheritance�ax tlue will become delinquent nine months aker the da�e ot death. 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 not check any other boxes and disregard Ihe amount shown above as Po;ential Ta�:Due. g � ]The information is The above iniormation is correct, no deductions are being taken,and payment will be sent ' correct. wi�h my response. Proceed to Sfep 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent,child,9randchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � �p/ I am a sibling of the deceased. 3 on reverse.) � 15% All o[her relationshlps (including none). p Changes or deductions The information above is incorrect and/or de6ts and deductions were paid. listed. Complete Part 2 and part 3 as appropnate on the back ot this torm. 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 tax form Retum filed by the estate representative. REV4500. Proceed to Step 2 on reverse. Do not check any otherboxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of(he following criteria: A. The tleceden�was legally responsible�or payment,and�he es�ate is insuHicient to pay the deductible items. B. Vou paid the debts atter the death of ihe tlecedent and can furnish pmoi of payment if requested by the department. (If addl�ional space Is required, you may attach 8 V2"x 11"shee�s of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation $ PART Tax Calculation _ 3 I± cu are makin a come i m y S ctien to the establishment tlate(Line 1)accoun!4alanca(Lne 2),er�rcent!ar.ab e(Line_„ please obtain a written correction trom the financial institution and attach it to[his form. t Enter the date the accoun�was es�ablishetl or titled as it exis�ed at Ihe da�e ot death. 2 Enter the total balance of the account including any interes�accrued at[he date of death. 3. Enter the percen�age of�he aCCoun�that is�axable to you. a First.determine ihe percentage owned by the decedent. '. Accounts that are held"in Vust for"another or others were 100%owned by ihe decedent. ii. For joint accounts established more[han one year prior�o�he date of death, Ihe percentage taxable is 100%divided by the to�al number of owners including�he decedent. (For example:2 owners= 50%, 3 owners=33.33%,4 owners =25%.e[c.) b. Next, divide the decedenfs percentage owned bylhe number of surviving owners or beneficiaries. 4. The amount subjec�to tae is determined by mul�iplying the accoun�balance by�he percent t�able. 5. Enter the b�al ot any debts and deductions claimed from Part 2. 6. The amount taxable is de�ermined by sub[rac�inq the deb�s and deductions from the amoun�subject to tan. Z Enter the appropriate tau rate irom S[ep 1 based on your rela[ionship to ihe decetlent. If indicatinq a di�ferent�ax rete, please sta�e �ai Use Only�anF r, _Vg4' yourrelationshiptothedacetlent ,. ��j��8f1[Ort�2ti8IW ' � ' 1. Da�e Established 1 n . �± -� � 2. Account Balance 2 S P�1� �.� � x � � �' �� 3. Percent Taxable 3 X �' 2 a-:.� � ;�. . , e � '-,•K 4. Amount Su6ject�o Tax 4 $ � ;��,,� #, ,. 5. Debts and Deduc�ions 5 - 4, ��$ �F.;,':: 6. AmountT�able 6 S a 6 � 7. Tax Rate 7 X m " ' ' e. Tax Due 8 $ � ' �� " 9. With 5%Discount(Tax x .95) 9 X $ �� . �� „t,,,t;�. St@P 2: Sign and da�e below. Retum TWO comple�ed and signed copies�o�he Regis�er of Wills lis�ed on�he fmnt of this form,� along with a check for any payment you are makinq. Checks must be made payable to"Register of Wills, Agent" Do not send payment directly to the Department of Revenue. Under penalry of perjury, I declare that ihe facts I have reported above are tme,correc[and complete to ihe best of my knowled9e and belie�. Work � i� 77'I n �.ru�- Home �`//'J '� y9 �'�3��?al5 Taxpayer Signature Telephone Number Date d� � IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DNISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 a v� a�� " �� n3� _.. - - •� �: o�` RECC.;,-� . . . - � . REG� " a �015 �ur, i �� o �l ^� �� o�e',;t,. ci,,��'. , � � �-,. �n ��.i �,, � lA� 1+.1 � ti'� � Q �tl q L \ �V _ \ �` , h; '�'. 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