The URL can be used to link to this page

Home My WebLink About06-19-15 wmmorvwen�rH os oennsnvpN�a - rMCNroraevcrvuE 9UREqu OF INOMOUaL Tq%ES AE�-��82 E%I l 1-961 OEGT.�BO6�1 ��HPPISBUrIG.Cq 1]10B-O601 RECEIVED FqOM: PENNSYWANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 020860 SHUGHART MICHAEL L 55 KELLY ROAD SHIPPENSBURG, pq 7725� ACN ASSESSMENT AMOUNT CONTROL -�--- �a�= NUMBER 15127987 � S13J4 -- - ESTATE INFORMATION: SSN: 162- ] I FILE NUMBER: 2114-1004 oECE�ENTNqME: SHUGHART CHERYLLYNN I DATEOFPqYMENL O6/19/2p75 I POSTMARK DATE: p6��2��5 I COUNTv: CUMBERLAND I DATEOFDEATH: pg�Z2�2��4 I � � TOTAL AMOUNT PAID: 513.74 REMARKS: CHECK# 101 INITIqLS: CJ sea� RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAVER eureenu or ix�rv�ow� inxes Po ,o. zaoso� Pennsylvania lnheritance 7 �� ^aR=sa�a= >A =�,�a-oso, a« pennsylvania InformationNotice �'4oeanarnervroraevervue � . And Taxpayer Response "`°,°°,^ R_CU�ii., � ... . . . _ .. , FILENQ2114q004��•-,�� R��;` ." _ ;, � � ACN151D987 �� ` - DATE OS-22-2015 1i15 JUIJ 19 F�112 .7 i � � . . _ TypeoFAccoun( -� Estate of CHERYL L SHUGHART � � , SSN 162-48-7477 Savings MICHAEL � SHUGHART �I�� ' �� Tmst SHIPPENSBURG Pp 17257 9622 CertifiCate ACNB BpNK provided the department with the information below indica[ing that at the death of the above-named decedent you were a join[owner or beneficiary of the account identified. Account No.95pgq9g Remit Payment and Forms to: Date Establishetl 17-p7qgg6 Accowt Balance REGISTER pF WILLS Percent Taxable $610b5 7 COURTHOUSE SOUARE X 50 CARLISLE PA 17013 Amount Suhject to Tae $305.33 Tax Rate Potential Tax Due X 0.750 $45.80 NOTE': I(tax payments are matle within ihree months of Ihe With 5%Discount(Tax x 0.95) $(see NOTE"� decedenYs date of death, deduct a 5 percent tliscount on ihe tax �� due. Any inheritance tax tlue will become delinquent nine months aNer ihe date of death. PART � SteP 1 : please check the appropriate boxes below. A �No tax is due. 1 am the spouse of the deceased or I am the parent of a decetlent who was 21 years old or younger at date of death. Proceed to Step 2 on reveise. Do not check any other boxes and disregartl the amount shown above as Potential 7ar Due. B �The informa�ion is The above information is correc�, no deduc�ions are bein correcL wi}h my response. 9laken, and Proceed to Sfe 2 on Payment will be sent P reverse. Donotcheckanyotherboxes. C �The�ax rate is incorrect. '� (Selec�wrrect tax rate at 4'S' I am a lineal beneficiary(parent, child, grandchiltl, etc.) of ihe deceased. right, antl complete Patl � 3 on reverse.) �Z� I am a sibling of the deceasetl. ❑ �5 e All other relationships (induding none). p ❑Changes or deductions The information above is incorrec�antl/or debts and detluctions were paid. listetl. CompletePah2andpart3as appropriate on(he back ol this to�m. E ❑Asset will be repotletl on The above-identified asset has been or will be repotled and tae paid with the PA Inheritance Tax inheritance tax form Retum filetl by�he estate representa(ive. REV-1500. Proceed to Step 2 on reverse. Do not check any o(her boxes. Please sign and date the back of the form when finished. ppRT Debts and Deductions 2 Allowable debts and deduclions must meel bolh of th?ne�nS alnd lheeestale is insuf�icient to pay lhe detluctible items. q. The decedent was legally responsible tor pay . g. Vou paid ihe deb�slf addd onal space is�requ r�ed nyou may attach 8 P/2"x 11PasFheets ofrpapest)d by the departmen . Description Amount Paid Date Paid Payee Total Enler on Line 5 of Tax Calculalion) $ PART Tax CalCulation If you are making a correction to lhe establishment date(Line 1)accounl ba�ance(Line 2),or percent taxable(Line 3), 3 please obtain a wrilten correclion from lhe fina�cial institution and attacM1 il to this form. �, Enter the date the account was established or titled as rt existed at the date of death. 2 Enter the total balance of the account including any interest accruetl at the date of death. 3. Enter the pe«entage of the account that is taxable to you. a. First,delermine lhe percentage owned by Ihe decedent. i. Accounts that are held"in Imsl for"anolher or others were 100%owned by lhe decedent 4 oµ,ners ii. bY��he�otal numbersof ownerUs nolud ng the dec dent r(Forhexamplef�e w�e s�=�4�n3 owne sbl 33.33�/divided =25%.etc.) b. Next, divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. q. The amount sublect to t�is determined by multiplying the account balance by ihe percent taxable. 5. Enter the total ot any debts and deduclions claimed irom Part 2. 6. Theamounttaoaba¢etaxratelfromStepbtbasedonyootelalon�shipttoothe'deceden(mountsub7ecttotax 7. En�ertheaPP P �4j��I�m�1t,�r,��,��"��`'�`z"'�x^ . I�indicating a different tax rate,please stales ' p�p�n� 1g` ' your relalionship ro the decedenL , � � '�,�� ,; '� �&�,r �t*.�'��:A�"��.�'�»`"�,t�' � �. DaleEstablished � P({[J w�� '�� i in i_S � .�- 2. Account Balance 2 X� a"'� � �;. ,.2 "'b+" 3. Percent Taxable 3 2' ' ,. .��.„� y, w� 4 z ns� � �i 3 ,� . ,�� 4. Amount Subject to Tax 4 ' _ •. � �� _'� 5. Debts and Deduclions 5 � , ' 6 $ p S� �F s �"S� �'`�i�:� g, AmountTaxable o 6' �.: � -� ' : 7 X ] .. �' t- ,� � a' �� r 7. Tax Fate i- S � �,rt'in:i}, a �.^'�sv�9* � g. Tax Due 8 $ $ �� "�� g, With 5%Discounl(Tax x .95) 9 X � �� :. � �� 4 � _ � SteP �,: Sign and date be�menty o`u areTma�k�9 PChetlks mus9be made payable Ro gRegis�ler o'f WilsseAge the Donnot sendorm, along with a check for any pay paymenl directty to the Department of Fevenue. Under penalty of perjury, I declare that the facts I have reported above are tme,correct and complete to the best of my knowledge and belief. y�Jprk Home 77G - 7�'b2- � ��c" �r (17� � U I� A' AJS Date Telephone Number Taxpayer Signature IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENU T�AXPAYERSOWITH SPECIAL HEARINGIAND OR SPEAKING N�EDS ONLY?8 S00 447302pRVICES FOR .� . � � 3 a � : �� Q � � x , ; -" � G ;:i U � �' ,. � � �,, �, . , ,. � � i,.� � ,�� i`i '� u? n � �i� _ ,� � �J � , o � � _ � � � » �J v` �� - ' n " � =y z �i - � Ci = r X, C _= , � .. . _ „a�vn� _ _ i �..: �'�;d?70 E�'�''+��' . _ ' �� = L� ZI W:� 6T P;�l" Si�� t � � � � sr , _. _ .. __ ��' �� ° � _ ��;oaa