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HomeMy WebLinkAbout06-29-15 (2)COMMONNiEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 28PE01 HARRISBURG, PA 1/1 I8-0601 RECEIVED FROM: DEVLIN FLORENCE 210 CUMBERLAND DRIVE CAMP HILL, PA 17011-6672 EYE PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: FILE NUMBER: 2115-0515 DECEDENT NAME: DEVLIN RAYMOND A DATE OF PAYMENT: 06/29/2015 POSTMARK DATE: 06/26/2015 COUNTY: CUMBERLAND DATE OF DEATH: 03/03/2015 REV1162EX(- 96) NO. CD 020907 ACN ASSESSMENT AMOUNT CONTROL NUMBER 15132477 $37.80 TOTAL AMOUNT PAID: $37.80 REMARKS: RECEIPT TO ATTY CHECK#154 INITIALS: CHI SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax PMBOX 280601 R BUPG PA 11128-0601 Information Notice And Taxpayer Response FLORENCE K DEVLIN 210 CUMBERLAND OR CAMP HILL PA 17011-6672 i pennsylvania DEPARTMENT xOF REVENUE N FILE NO. 2115-0515 ACN 15132477 DATE 06-17-2015 Estate of RAYMOND A DEVLIN Date of Death 03-03-2015 County CUMBERLAND Type of Account Savings Checking Trust X Certificate o F\1 CJ l 3 rV 1 M s T BANK provided the department with the information below indicating that at the death pt the _ shove -named decedent you were a ioint owner or beneticiary of the account identified. c> PART Step 1 : Please check the appropriate boxes below. 1 AE] No tax is due. gThe information is correct. C The lax rate is incorrect. (Select correct tax rate at right, and complete Part 3 on reverse.) D [—] Changes or deductions listed. E F-] Asset will be reported on inheritance tax form REV -1500. 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. The above information is correct, no deductions are being taken, and payment will be sent with my response. Proceed to Step 2 on reverse. Do not check any other boxes. F5% Remit Payment and Forms to: Account No. 25004920674395 12% 1 am a sibling of the deceased. Date Established 02-02-2004 15% REGISTER OF WILLS Account Balance $ 630.03 1 COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $ 315.02 Tax Rate X 0.120 NOTEIf tax payments are made within three months of the Potential Tax Due $ 37.80 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 atter the date of death. PART Step 1 : Please check the appropriate boxes below. 1 AE] No tax is due. gThe information is correct. C The lax rate is incorrect. (Select correct tax rate at right, and complete Part 3 on reverse.) D [—] Changes or deductions listed. E F-] Asset will be reported on inheritance tax form REV -1500. 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. The above information is correct, no deductions are being taken, and payment will be sent with my response. Proceed to Step 2 on reverse. Do not check any other boxes. The information above is incorrect and/or debts and deductions were paid. Complete Part 2 and part 3 as appropriate on the back o/ this form. The above -identified asset has been or will be reported and tax paid with the PA Inheritance Tax Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. F5% 1 am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. 12% 1 am a sibling of the deceased. 15% All other relationships (including none). The information above is incorrect and/or debts and deductions were paid. Complete Part 2 and part 3 as appropriate on the back o/ this form. The above -identified asset has been or will be reported and tax paid with the PA Inheritance Tax Return filed by the estate representative. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 t 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 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 If you are making a correction to the establishment dale (Line 1) account balance (Line 2), or percent taxable (Line 3), please obtain a written correction from 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 of the account that is taxable to you. a. First, determine the percentage owned by the decedent. i. Accounts that are held "in trust for" another or others were 100% owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100% divided by the total number of owners including the decedent- (For example: 2 owners = 50%, 3 owners - 33.33%, 4 owners = 25%, etc.) 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. 5. Enter the total of any 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 u3 Official Use Orgy ❑ AAF.„ your relationship to the decedent: nPA Department of fi@YCnU@" 1. Date Established 1 ¢ < 2. Account Balance 2 $ PAu°r 3. Percent Taxable 3 X f ` 2 w , 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - ¢°' 6. Amount Taxable 6 $ 7 Tax Rate 7 X S. Tax Due 8 $ 7 „ 18 7 7 9. With 5% Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to "Register of Wills, Agent" Do not send payment directly to the Department of Revenue. Under penalj�yy of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. /1 Taxpayer 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 W 10