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HomeMy WebLinkAbout07-09-15 (2) BUREAU INDIVIDUAL TAXES 28 PO BOX 280601 Pennsylvania Inheritance Tax pennsytVania HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE -""-" REV-1543 EX UOCEXEC (88-12) And Taxpayer Response FILE N0.21 I�j-- 7 ACN 15128200 DATE 05-25-2015 REGISTER OF WILLS r JUL Type of Account 2015 JUL 9 P� 1m u 3 12 Estate of KATHY A UHL Savings SSN Checking CLERK OF Date of Death 04-02-2015 Trust KENNY R JOHNSON ORPHANS' COURT County CUMBERLAND Certificate 131 REX DR CARLISLE PA 17015-OUMBERf..0D CO PA 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.7760506063 Remit Payment and Forms to: Date Established 12-17-2013 REGISTER OF WILLS Account Balance $350.00 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 175.00 Tax Rate X 0.150 Potential Tax Due $26.25 NOTE*: If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE*) 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 W,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 F—]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 F—] 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. PART TT Debts � ���Deductions Allowable debts and deductions must meet both of 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 of the decedent and can furnish,proof.of payment if requested by the department. (If additional space iorequired,you may attach 81/2^x11^sheets ofpaporj . . Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PA ~F2Ox Ca|[|U|at'og �--�--/ If you are making acorrection tqthe establishment date account balance(Line 2),mrpercent taxable(Line 3), please obtain a written correction from the financial institution and attach it tothis 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 iutaxable 0nyou. u. First,determine the percentage owned bythe decedent. . i. Accounts that are held"intrust for"another or others were 100%owned by the decedent. i(. For established more than one year prior to the date of death, the percentage taxable is 100%divided bythe total number ofowners including the decedent. (For example:2owners=50%' 3owners~33.33%'4owners ~25%.etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject 0otax indetermined bymultiplying the account balance bythe percent taxable. 5. Enter the total ofany debts and deductions claimed from Part 2. - ' G. The amount taxable iadetermined bysubtracting the debts and deductions from the amountsubject to tax. 7. Enter the appropriate tax rate from Step 1 based unyour relationship 0uthe 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 andsigned copies to the Register ofWills listed onthe front ofthis form, along with ucheck for payment you are making. Checks must bemade payable 0o"Register ofWills, Agen¢.^ Donot send payment directly tothe Department nfRevenue. Under penalty ofperjury, |declare that the facts |have reported above are true,correct and complete\othe best ofmyknowledge and belief.