HomeMy WebLinkAbout06-03-15 BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax pennsyLvania
PO BOX 2806D1 DEPARTMENT OF REVENUE
HARRISBURG PA 17128-0601 Information Notice REV-1543 IX D-EXEC M-11)
-And�aVaye�Besponse
RECOR-1, FILE NO.2115-0385
DATE 05-25-2015
' Type of Account
CLE'-', �F
Estate odK8|LDREDAJEZ Savings
0Rp>I A�,`J' � ��- Checking
Date nfDeath O3-22-2O15 Trust
� '`� ^' c"h�"CUK48ERL�ND �-� ^~~
LINDA A 3MELT� ' � ..~..., L_�Ceumcaoz
4 WHEATLAmD DR
mECHAwICSBUQa PA 17050'1600
witMETRO BANK provided the department
h the the infO 8UD bak)vv indicating that at the death of the
above-named decedent you were a joint owner or beneficiary of the account identified.
Account No.626429872 Remit Payment and Forms to:
Date Established 01-30-2004 REGISTER OF WILLS
Account Balance $46,748.64 1 COURTHOUSE SQUARE
Percent Taxable X 50 CARLISLE PA 17013
Amount Subject to Tax $23,374.32
Tax Rate XD.150
NOTE*: \�� �ma��w�in�emmo�s��m
�
Potda|TaxDue � ,-'��-
decedent's date ofdeath,deduct a5percent discount onthe tax
With 5%Discount(Tax x0.S5) duo. Any inheritance tax due will become delinquent nine months
after the date nfdeath.
PART Step 1 : Please check the appropriate boxes below.
A [-�NK» is due. mm
��� � � U � 8he spouse of the deceased orUammthe parent of a decedentwho was
--' 21 years old or younger at date of death.
Proceed h»Step 2onreverse. Donot check any other boxes and disregard the amount
shown above aaPotential Tax Due.
F-1 ` '
B
The\�orma�onio The above information iucorrect,nodeductions are being taken,and payment will besent
`-�uornaoi. with my ao.
Proceed/oStep 2 on reverse. Donot check any other boxes.
O �-�The tax o�eiuinoorm�� 45�� |amu|ine�|bonefioiary (par�ni' ohi|d. Qmndnhi|d �ojof the deceased.
L-� � F-]- � '
(Select correct
right,and complete Part F-1 12% \anoa8dingofthe deceased.
8onreveruo.) �-�
F-] 15% All other relationships (including none).
D / (Ch anrdoduuhonu The inh�maUonabove iuinconoo and/or deb�and doduuhonewempa�.
�-�|ia1nd. Complete Part 2and part 3aoappropriate onthe back o/this form.
E Asset will boreported on The above-id entifi ed asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed bythe estate representative.
REV-1580. | Proceed(oStep 2onreverse. Donot check any other boxes.
|
Please sign and date the back Dfthe form when finished. | \
~
PART
Debts and Deductions
Allowable debts and deductions must meet both o/the following criteria:
A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death ofthe decedent and can furnish proof of payment ifrequested bythe department.
(If additional space is required,you may attach 8 1/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total (Enter on Line 5 of Tax Calculation) , $
PA Tax Calculation
�--�—�
If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3).
--
please obtain a written correction firom.the financial institution and attach it to this form.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage ofthe account that iotaxable 8myou.
a. First,determine the percentage owned bythe decedent.
i Accounts that are held"in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts establishedmore than one year prior tothe date ofdeath,the percentagetaxable ia1UO%divided
bythe total number ofowners including the decedent. (For example:2owners=5O%.3owners=33.33%.4owners
~2SY&.etcj
b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
b. Enter the total cfany debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
T. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent.
If indicating a different tax rate,please state Official Use Only [I AAF
your relationship to the decedent: PA Department of Revenue
2. Account Balance 2 $ PAD
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 4
Step 2: Sign and date below. Return TWO completed anduigned copies to the Register ofWills listed on the front ofthis form,
along with acheck for any paymentyou are making. Checks must hemade payable Vo"Register ofWills,Age/t.^ Donot send
payment directly 0othe Department cdRevenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correctandoomp|e!etothobest ofmyknowledge and
belief.
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