HomeMy WebLinkAbout05-29-15 BUREAU OF INDIVIDUAL TAXESj Pennsylvania Inheritance Tax pennsyLVania
PO BOX 280601 y
HARRISBURG PA 17128-0601 Information NoticeDEPARTMENT OF REVENUE
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REV-1543 E%DocE%EC (08-12)
And Taxpayer Response
{�t"i-1G Q� FILE NO.21 15— S9rlREC(} � w ACN 15128198
f ~ '.' i LL5 DATE 05-25-2015
29 q1M 11 ail Type of Account
_ Estate of KATHY A UHL Savings
G L E r SSN Checking
4 j��} ; ' (' i Date of Death 04-02-2015 Trust
MARION F WELLS County CUMBERLAND Certificate
500 LANCASTER AVE GUhbC;,..
ENOLA PA 17025-2636
METRO BANK 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.626561799 Remit Payment and Forms to:
Date Established 03-24-2005 REGISTER OF WILLS
Account Balance $281.25 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013 .
Amount Subject to Tax $ 140.63
Tax Rate .,X-��gp t�! fir' �
NOTE': If tax payments are made within three months of the
Potential Tax Due
G' 3 decedent's date of death,deduct a 5 percent discount on the tax
With 5%Discount(Tax x 0.95) $ (see NOTE`) a.D / 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 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 [—]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 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 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 F—]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.