The URL can be used to link to this page

Home My WebLink About06-17-15 (2) ,�REa� o. ,xo��,o�.� ,a=Es PennsyNania lnheritance Tax �`��: pennsylvania vo eox xeaco� Informati0n NOtice oevnarmervr or aevervue XPRR1590R6 PG 1]IZfi-0601 ne�+zn u m.00_io+rn And Taxpayer Response Fi�E No.zi-�> -C��i�. ACN 15130707 �j � - . � �� DATEOFO&2015 T e of ACcoun� � p�I '7 C�g YP i5 �Uld 17EstateotANNAMRUSS �Savings - SSN 179-12-5620 Checkin9 " '- 2015 Tms� JOANNE M NAGLE � �-�-� '��ntyEUW18ERLAND Certificate 43 RVE LN ��'y;�,:.-�. ' . .. „ PALMVRA PA 170�8-3071 POSTMAkK cu 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. Remit Payment and Forms to: AccountNo.3549 Dale Established OB-0&1972 REGISTER OF WILLS Account Balance $32,611.92 1 COURTHOUSE SOUARE CARLISLE PA 170/3 PercentTaxable X50 Amount Subject to Tass $ 16,305.96 Tax Fate X 0.045 NOTP: If tax payments are made within ihree monihs of the Potential Tax Due $733.77 decedenCs date of death, deduct a 5 percent discount on the tax With 5%Discount (Tax x 0.95) $(see NOTP) due. Any inheritance tax due will become delinquent nine monihs after Ihe date of dea�h. PART $tBp 1 : Please check the appropriate boxes below. 1 n �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 rever5e. Do not check any other boxes and disregard the amount shown abwe as Potenfial Tax Oue. g ❑The in�ormation is The above informalion is correct, no tleduclions are being taken,and payment will be sent correcl. with my response. Proceed ro Step 2 on reverse. Do nof check any other boxes. p ❑The tax rate is incorrecL � 4.5% I am a lineal bene�iciary(parent,child,9randchiltl, etu)of the deceased. (Select correct tax rate at ri9h�,and complete Part � �2/ I am a sibling of�he deceased. 3 on reverse.) � 15% All other relelionshlps (Including none). p �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�orm. E I\/I Asset will be reported on The above-identified asse�has been or will be reported and tac paid with the PA Inheritance Tav '-Y�inheritance tax form ReNm filed by the es[ate representative. REV-1500. Proceed ro Step 2 on reverse. Do not check any ofher boxes. � � Please sign and date the back of the form when finished. / PART z Debts and Deductions Allowable debts and deduc�ions mus�meet both of�he tollowing cri�eria: A. The decedent was legally responsihle for paymenL and the estate is insuflicient to pay[he deductible items. B. Vou paid the debts afler the death of the tlecedent and can fumish proof o�paymen[if requested by[he department. (If additional space is required, you may attach B V2"x 71"sheets oi paper.) Date Paid Payee Description Amount Paid Total En�er on Line 5 of Tax Calculation $ PART Tax Calculation 3 Ii you are making a correction to[he establishment date(Line 1)account balance Line 2 , or please obtain a written correction trom the financial insiitution antl atlach it to thie torm.� cercent taxable(Line 3), L Enter�he da�e�he accoun�was established or�itled asit existed atthe date ofdeath. 2 Enter the�o�al balance of the accoum including any interes�accrued at the tla�e of death. 3 Enter the percentage oi[he account ihat is taxable to you. a. First,determine the percentage owned by the tlecedent. i. Accounis that are held"in imst for"another or others were 100%owned 6y ihe decedent. ii. Por joint accounis established more ihan one year prior to the tlate ol tleath, the percenta9e taxable is 700%dividetl by the�o�al num6er of owners including the decedenL (For example:2 owners=50%,3 owners=33.33%,4 owners =25%, etcJ b. Next,divide ihe decedenfs percentage owned by the number of surviving owners or beneficiaries- 4. The amount subject to t� is delerminetl by multiplyin9 the acwunt balance by the percent taxable. 5. Enter Ihe total of any deb�s and deductions claimed from Part 2. 6. The amoun�taxable is de[ermined by sub�racting the debts and deductions from Ihe amount subjec�to�ax. Z Enter[he appmpriate tax rete from Step 1 based on your relationship to the decedent. If indicating a different tax rate.please state � �� .,�.,y � your relationship to the decetlent: 1. Da�eEstablished 1 ' `� � ��`��Pr� � ��@V�8Tii1� 3 .�� .' s 2. Account Balance 2 S pp�,{9�;. ` i � x�'''`+�'� tu4x , �3�t��iix�tr,tl'��. 3. PercentTaxable 3 % ��pr��k'��g�'�"�� r*� 4aa +�� 2 '�'=x s ch; -.. . 4. Amoun�Subjec�to Tax 4 $ - �` � . •--� 5. DebtsandDeduaions 5 - 3��'�` F�"�` � ��'�� '"� �� 4 `'`w'�3�"^� �;x� 4 ;�;:;T��;,�. ..y,� �< ., 6. AmountTaxable 6 $ - �. Tax Hate �� X $� .,a.rw ,�.�`� _..��+—� auh`#ta.;".. 8. TaxDue g $ ��3;,� a:—.�. �' �a��:e�..e„ �"�^Y-.a* t a-� �� v 9. Wi�h 5% Discount (Tax x .95) 9 X $ � '�� "'�` � 5 ��"��`°� . , �.fs.. .�,.,bW��usr�-tt .,W�.r�k�s.u:.-��. StOP 2: Sign and date below. Return TWO completed and siqned copies to ihe Register of Wills listed on ihe trant of this�orm, along with a check for any paymem you are making. Checks must be made payable to"Register of Wills,A9ent." Do not send paymen�directly�o�he Depatlment of Revenue. Under penal�y of perjury, I declare ihat ihe facts I have reported above are tme,correct and complete to the best of my knowledge antl belief. Work � n/�A " ' �� Home �� .�� h� �yanpayer aignacure " Telephone Number ate 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 �'� aSn y 3 � � n !� �� ` \/ ii? � � t�} L) t0 � K_� L � ��0 � = � � � r T _. � , �� r = � n > � _ ��. A �' rx ?� = U, � � � � �J: � � v = y • �� Y 1 - � E 4 ��