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Home My WebLink About06-16-15 REV-1162 E%111 901 COMMONWEALTH OF PENNSVLVPNIP �EPAXTMENi OF PEVENUF BVFEAU OF INDI VI�UPL TPXES oEPT 300fi�1 naamseuen vn n�se osm pENNSYLVANIA pECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD OZOH4O DERAMO JEANETTE 7 BRIARWOOD COURT MECHANICSBURG, PA 17050-3182 ACN ASSESSMENT AMOUNT CONTROL NUMBER ---- ---- .--�- 1eie 15130591 � 550.34 ESTATE INFORMATION: sSN�. I FILE NUMBER: 2115-067� I DECEDENT NAME: DERAMO LENA � DATEOFPAVMENT: 06/16/2015 � POSTMARK DATE: 06/15/2015 � c0uN7v: CUMBERLAND I DATEOF DEATH: 07/21/2014 � � TOTAL AMOUNT PAID: 550.34 REMARKS: CHECK# 3827 INITIALS: CJ sEA� RECENED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS eoa�,+u or �xomoun� �nxEs Pennsylvania lnheritance Tax � �� PennS7�Van�a PO BO% 280[Ol �n(OffPdSlOfl NOSICQ �� DEPAPTMENT OF PEVENOE NpRFISBVRG PR ll1I0-06Y\ an�ur i m¢ And Taxpayer Response Fi�E Na 2i -�h' , � ��:��.-.:_ . � =5 OF ncNisisossil , l,'LF � � �- � - DATE 06-08-2015 %�°�15 J'JtJ 16 i'�l 1 G3 1vPeain��o�� i�Es�ate of LENA DERAMO Savings �„SS,K196-28-8260 Checking �i� �'-� 4 Tmst JEANETTE DERAMO CUId � �'.OWUrrtyCUMBERLAND Certificate 7 BHIARW�OD CT MECHANICSBURG PA 17D50-3182 FULTON BANK Nn provided the department with the information below indicating that ai the death oi the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccounlNo.3625 Date Establishetl 09-13-2011 REGISTER OF WILLS Account Balance $2?3�.43 1 COURTHOl1SE S�UARE CAFiLISLE PA 17013 Percent Taxable X 50 AmountSubjecltoTass $1,11872 Tax Rate X 0.045 NOTE': If tax payments are made within ihree monihs o(the Potential Tax Due $50.34 decedenYs date oi death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheri[ance tax due will became delinquent nine monihs afler�he date of death. PART $t2P 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 ro Step 2 on reverse. Do nof check any other boxes antl tlisregard fhe amount 5hown above as Potenfial Tax Due. g �The information is The above in(ormalion is correct. no deduclions are beinq taken,and paymen[will be sen[ carrect. wi�h my respanse. Proceed fo Sfep 2 on reverse. Do not check any other boxes. p ❑The lax rate is incorrecL � 4.5% I am a lineal beneficiary(parent,child, grandchild e�c.)ot the deceased. (Selacl correct�ax ra�e at ❑ right, and complete Part �p/ I am a siblinq of the deceased. 3 on reverse.) � 15% All other relationships(including none�. p ❑Changes or deduc�ions The information above is inwrrect and/or deb�s and deduclions were paid. listed . Complefe Part 2 and part 3 as appropriate on the back of this lorm. E �Asset will be reponed on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheri�ance t�form ReWm�iled by Ihe estate representa�ive. REV-1500. Proceed fo Step 2 on reverse. Oo nof check any other boxes. i Please sign and date the back of Ihe form when finished. �� PART Z Debts and Deductions Allowable debis and deductions must meet both of the followin9 criteria: A. The decedent was legally responsible for payment, antl the estate is insufficient to pay the deductible items. B. Vou paid the debts afler ihe death of[he decedent and can fumish prooi o�payment if requested by�he departmenl. Qt additional space is required,you may attach 81/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 H you are making a correction to ihe estabiishment tlate Line 1 account balance Line 2 ,or ( ) ( ) percent taeable(Line 3), piease abtain a writlen corteciion from lhe tinancfal fnstilution and attach it�o ihis form. L Enter the date the account was established or titled as it existed at the date of death. 2. Enter ihe total balance of the accowt including any interest acemed al ihe date of dea[h. 3. Enter the percentage of ihe acwun[Ihat is taxable[o you. a. Firs�,determine�he percentage owned by the decedent. i. Accounis that are held"in irust for"another or others were 100%owned by ihe decedent. ii. For joint accounis established more ihan one year prior ro the date of death, ihe percentage tavable is 100%tlivided by Ihe total number of owners including the decedenL (For example:2 owners=50%, 3 owners= 33.33%,4 owners =25%.etc.) b. Next, divide the decedenfs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tac is determined by multiplying the account balance by�he percent taxable. 5. Enter the�otal of any deb�s and deduc�ions daimed from Pah 2. 6. The amount taxable is determined by sub�racting the debts and deductions from�he amount subjec�to tax. 7. Enter ihe appropriate tax rate hom Step 7 based on your relationship to the decedent. If indicating a different tax rale, please state � � your relationship[o the decedenT : �' z�'��3 �� ° ��}� � 1. Da�e Establishetl 1 .�Y'��s,� r h W� 2. Accoun�Balance 2 $ P1� - �'�� . �� e" 3. PercentTaxable 3 X ��'` "�4^—e��,r�^�m�+�� "�' "�� "'��'�' 4. �Amoun�Subject�o Tax 4 $ "�� y.. ` � ` ',�� x � ` ri' 'S�� t ^S s`&4 ��d.� � 5. Debis and Deductions 5 - ' : �3 p�, �,�� _ ' 6. Amow[Taxable 6 $ $f' �,��. ,� #s; �` /. lax Mata ] % � ,:.,... ' ' :� "�''5+ ' ,J�� . :��'*.•�'r-$. 8. Tax Due g $ � ^ ` '�' � x r,r ,�,a;,a��'�:.,.�. 9. Wi�h 5%Discount(Tax x .95) 9 X $�'� �� + .w..�,rt >:„,:�; St@F) 2: Sign and da�e below. Re�um TWO completed and siqned copies to the Re9ister of Wills Ilstetl on the front of�his form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent" Do not send paymem diredly to�he Departmenl of Revenue. Under penalry of perjury, I declare that�he facts I have reported above are true, correct and complete to the best of my knowledge and beliet. q � �q � Work �e'�ire� 4nn_mp11o ) �.J � t lY Home 717- (091-57Z9 OL��ls�aolS Taxp r 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 � � � �m� � c� �� r-,EG0�9C � �`�� m m - =G15?.�_.. . . .._ ➢o d �is d!J� 15 P'�1 1 �3 � � ��E:.�„ �� , �"�:s' cc cu�a,.,� �a�;�� r;. _ � , `i �, il j� (�� 0 _ O '' h] � ` � °i � �_ � e s � � � +� ➢ e � _ � � N .. n r s o �' `� �.' = e — w '_ ,:, _ � � _ �° c; — �n _ "1 Ti - ? � il) µ - r � _ � �