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Home My WebLink About07-27-15 ,�R�,� oF �xo,��oW� r.xE� Pennsylvania lnheritance Tax ��j �� Penn5yLV81lld 0o aox zaoso� Information Notice ��C,17 oeanaimervloF Aevenue XPRRISBUR6 PR ll128-0601 eiv-um u w.sao ioe-�n AndTaxpayerResponse Fi�ENo.2rty-05 =`I RECOP,D[D pFFICE OF oAreoszsiois �� '- � �- .. „ _.,, " 2D15 JUL 27 F�1 2 38 TVPa ��n��°�� Eslate of CHRISTINE EVEFHART �Savings C! �� Checking ORPr�;';: ',. DateofDeath03-0&2015 Tmst CAROL L KILK❑ CoUn�yCUMBERLAND Certificate CUMf-P.' :�. � ll7 4TH ST � � � , BOILING SPRINGS PA 1]00]-9501 - BELCO connuNirv CkEDIT UNION provided the departmen[with Ihe information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of Ihe account identified. Remit Paymenl and Forms to: Account No.891415 Uate Established 0406-2011 REGISTER OF WILLS Acwunt Balance $2,962.68 1 COURTHOUSE S�UARE CARLISLE PA 17013 Percent T�able X 50 Amount Subject to Tzc $1.481.34 Tax Rate X 0.150 NOTP: If tax payments are made within three manths of the Potential Tax Due $Z222� decedenPs date of death,detluct a 5 percent tliscount on the tax With 5%Discoun� (Tax x 0 95) $(see NOTE') due. Any inheritance tax due will become delinquen�nine mon�hs akerthe date ofdeath. PART StBp 1 : Please check the appropriate boxes below. 1 n ❑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 fo Step 2 on�everse. Do nof check any ofher boxes antl disregard the amount shown above as Potenfial Tax Due. g ❑The informa�ion is The above intormation is correct, no tleductions are being taken, and paymen[will be sent correcl. with my response. P�oceed to Step 2 on reverse. Oo not check any ofher boxes. p �The tax rete is incorrecL � 4.5% I am a lineal beneficiary(paren�,child,grandchild,etc.)of�he deceased. (Selec�correcl tax rale al righl,and comple[e Part �p/, I am a sibling of the deceased. 3 on reverse.) � 15% All o[her relationships (including none). � �I sted9es or deduc�ions The inf Complefe Part 2 and part 3 as appropnate on�the back of th s Porlm. E ❑Asset will be reported on The above-iden(ified asse[has been or will be reported and ta�e paid with the PA Inheritance Tax inheritance tax form Return filed 6y the estate representative. REV-1500. Pmceed fo Step 2 on reverse. Do not check any other boxes. � Please sign and date the back of Ihe form when finished. PART z Debts and Deductions Allowable deb�s and deductions must meet both o�the following criteria: A. The decedent was legally responsible for paymen[,and ihe estate is insuHicient to pay the deductible items. B. You paid the debts aher the death of the decetlent antl can furnish proof of payment if requested by the depatlment. (If additional space is required,you may atlach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid c Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a wrrection to the esfablishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written corredion lrom Ihe financial Institutlon antl attach it to thls(orm. L Enter ihe date the account was established or titled as it existed at the date of death. 2. En�er the[otal balance of Ihe account including any in�erest accruetl at�he date of death. 3 En�er the percentage of the accoun(that is taxable to you. a. Firs�,determine the percentage owned by the decedent. i. Accounts ihat are held"in[mst for"another or o�hers were 100%owned by the decedent. ii. For joint accaunis established more ihan one year prior b the date of death, the percentage taxable is 100%tlivided by the to�al number of owners including the decetlent. (For example:2 owners=50%, 3 owners=33.33%, 4 owners =25%,etc.) b. Next,divide the decetlenYs percentage owned by the number of surviving owners or beneficiaries. 4 The amouM subjec[�o tae is determined by mul�iplying�he accoun�balance by the percent taxa6le. 5. Enter the rotal of any debts and detluctions claimed from Part 2. 6. The amount taxable is determined by subhacting the tlebts and deduc�ions from the amoun�subject to tae. 7. Enter ihe appropriate tax rate fmm Step 7 based on your relationship to the decedent. �intlicating a tlPerent�ar rate,plea {q ,SN� : ��s��'y� our rela�ionshi to the tlecedent: IJ � 1. Date Es�ahlished i -- n- �C/ / ��.,�� P��pa��f '"� 2. Accoun[Balance 2 $ c�9�oO� �jR P� ��k � � �� 3. PerceniTaxable 3 X �'��„�� " '� � '� 2 y � � .. w� 4. Amount Subject�o Tax 4 $ �1 '� .' � � r 5. Debis and Deductions 5 ✓ , ��°�`� 6. Amoun(Taxa6le 6 $ rj'.�� , �. Tax Rate 7 X � . � Q fi �� - B. Tae Due 8 $ � $�'n � _ � . 9. With 5% Discount (Tax x .95) 9 X �;;; .SteP 2: Siqn and date below. Return TWO completed and si9ned copies to[he Register of Wills listetl on the imnt of ihis form.� along with a check for any payment you are making. Checks must be made payable to"Regis�er of Wills,Agent." Do not send payment directly to the Depariment of Revenue. Un enalty of perjury, I decl re tha�the facts I have reported above are tme,correct and complete to[he hes[of my knowledge and lief. Work Home � ' _ -� � Taxpayer Si nature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-g327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 r eurzeno nr �xomoun� raxes pennsylvania lnheritance Tax �'� � pennsylvania POBO% t006�1 �� OEPAFTMENTOFFEVENIIE XANRSSBIIMGPA I]12B-0601 InformationNotice ,,, , , , � And Taxpayer Response Fi�E ho.2i—�5�1�6=`{ RECORD � ^FFICE OF ncN ieiaas2s � � oaTe os-zs-zai s ?�1$ JUL 27 F(9 2 38 rvPe oi n��a��r Estateof CHRISTME EVERHART Savings C;_:-, . .- X Checkin9 ORFH;. ; _ ' oa�eo��eamoa-oa-zo�s r�us� CAB�L L KILKO � CountyCUMBERLAND Cehificate 117 4TH ST ��'1�'�-�"'. � .�- . BOILING SPRINGS PA 17007-9501 ae�co COMMUNITY CREOIT ur+xoN provided the department with the intormation below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment antl Forms�o: Acwunt No.891915 Date Established 0406-2017 REGISTER OF WILLS Account Balance $4,06926 1 COURTHOUSE S�UARE CAfiLISLE PA 17013 Percent Tanable X 50 Amoun�Su6ject to Tae $2,034.63 Tax Rate X 0.150 NO7E': If tax paymenis are made within three monihs of the Potential Tax Due $305.19 decedenPs date of dea�h,deduc�a 5 percen�discoun�on the�ax With 5%Discoun� (Tax x 0.95) $(see NOTE') due. Any inheritance lax due will become delinquent nine months atter ihe date ot death. PART $tep 1 : Please check the appropriafe 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. Pmceetl to Step 2 on reverse. Do not check any other boxes and disregard the amoun[ shown above as Potential7ax�ue. g �The information is The above in�ormation 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 6oxes. ��The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parenl,child,grandchild, etc.) of the deceased. (Select correct tax rate a� righl,and complete Part � �p=/, I am a sibling of the deceased. 3 on reverse.) � 15% All other rela�ionships(inclutling none). p 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 ol this torm. E ❑Asset will be reported on The above-identified asset has been or will be reported and tae paid with ihe PA Inheritance Tax inheri�ance lae�orm Retum filed by the es�ale represen�ative. 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 Z Debts and Deductions Allowahle deb�s 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. Vou paid ihe de6ts afler the death of�he tlecedent and can furnish proof of payment if requestetl by the department. Qf additional space is required, you may attach 81/2"x 17'sheets of paper.) Date Paid Payee Descriplion Amount Paid c To�al Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correctian to the establishment date Line 1 account 6alance Line 2 , or ( ) ( ) percen�taxable(Line 3), please obtain a written corredion irom ihe tinancial Institutian antl attach it to�his form. L Enter the da[e the account was established or titled as it existetl at the date of death. 2 Enterthetotal balance ofthe accountincludinq anyinterest accrued atthe date ofdeath. 3 Enter the percentage of the account tha�is taxable to you. a. Firs�,determine Ihe percentage owned by�he tlecedent. i. Accoun�s that are held"in hust for"another or others were 700%owned by the decedent. ii. Por join[accounis es�ablished more than one year prior to�he date of death,the percentage taxable is 100%divided by the�o�al number of owners including�he decedent (For example:2 owners=50%,3 owners=33.33%,4 owners =25%, etc.) b. Next,divide ihe decedenPs percentage owned 6y the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percwt taxable. 5. Enter the total of any debis and deductions claimed from Part 2. 6. The amoun�[axable is de�ermined by subtrac[ing the debls and deductions from[he amount subject�o tax. 7. Enter the appmpriate tax rate from S�ep 1 based on your relationship to�he decetlent. If indicating a different tax rate, pleas sta � "`�{ (�({'j�jal USB flrfly�]pqp your relationship to the decedent: L. ��'s.- ��,pep�y�tai Flevenue 1. DateEslablished 1 � O / ,�._ . �+ „�,, *> i;. 2. Account Balance 2 $ � P��_ 3. PercentTaxable 3 X j �� *��. .dw. �5 �rr t� 4. Amount Subject to Tax 4 $ �-� ��, «.¥ v. , 5. Debis and Deduc�ions 5 - 4'^,' . y� 6. Amount Taxable g $ $ `.�� w 7. Tax Rata 7 X �w�� 8. Tax Due g $ ("� ? � * 8 r '�„ ' �� *a'x;� �. 9. With 5%Discount(Tax x .95) 9 X „�' , Step 2: Sign and date helow. Retum TWO comple�ed and signed copies to[he Register of Wills hsted on the hont of this form.�� along with a check for any payment you are making. Checks must be made payable to"Register of Wills, AgenL Do not send payment direcity to the Department of Revenue. Under p nalty of perjury, I declare that ihe facis I have reported above are ime,correc[and complete to Ihe best of my knowledge and beli . r� — J Work i Home ' 7 '' Taxpayer Sig ature � 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 FOfl TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 .. _� _. v1c- \ �� a � � o � �� RECOROFD OFFICE OF � � REG"�` � :':ILLS ?O15 JUL 27 F�I 2 38 ORPI ' CUM�EI � � (a �J ._� � � � �_ � � i,� � 1 �� 'L� �i� `I �\! �\ � � i lV i!i � b. j) � � _ i � / � „ (,. t V\ � � \' n y \ � � �� - � � , \ i � . _ � � � = � � � _ � �� _ ; - ti � 7 = ; �b�s�,`;,m _ i� q�a c_ , - Nv �" ,� i ' m a o � o � m ` _ � ( ' ; (( ; ;