HomeMy WebLinkAbout08-04-15 B0REA0 °F 1XD1°�°0"� T"'E� Pennsylvania lnheritance Tax �� ��-� PennS�/�V81lld
PO B�X 2806Pt DFGAPTMENTOFflEVENUE
w.xa�seuae n v�te-ocai IMormation Notice ����
And Taxpayer Response "`�"""�`"�" `"•-".
Fi�e No.zi ia-oess
ACN 15138990
DATE 07-21-2�75
Type of Account
Es�ate o�SALVATORE J VALVO Savings
Checking
Date of Death OB-30-20�4 Tmst
>. RANOOLPH P VALVO CountyCUMBERLAND Certificate
212 ALLENDALE WAY � o
CAMP HILL PA 17011-8402 C � cn � m
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SANTANOER BANK provided the department with the information below indicating that at the death of the
above-named deceden[you were a joint owner or beneficiary of the account identified.
Account No.7678297114 Remit Payment and Farms lo:
Date Establishetl 09-18-2013 REGISTER OF WILLS
Accoun[Balance $86.78521 1 COURTHOUSE S�UARE
CARLISLE PA 17013
Percent Taxable X 100
Amoun[Subject to Tax $86.78521
Tax Rate X 0.150 NOTE': If tax payments are made within three mon(hs of the
Potential Tax Due $13,017J8 decedenYs date of death, deduct a 5 percent discount on the tax
With 5% Discount(Tax x 0.95) $ (see NOTE') due. Any inheri�ance�ax due will berome delinquent nine months
after the date of death.
PART StBP 1 : Please check ihe 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 Sfep 2 on reverse. Do nof check any nther boxes and disregard the amount
shown above as Pofential Tax Due.
g �The information is The above information is correct, no deductions are being takea. and payment will be sent
correcl. with my response.
Pmceed fo Step 2 on reverse. Do not check any other boxes.
p �The tax rate is incorrecL � 4.5% I am a lineal 6eneticiary(paren�,child, grandchild, e�cJ of the deceased.
(Select correct tax rate at
righ[, and comple[e Part � �p� I am a sibling of ihe deceased.
3 on reverse.)
� 15% All other relatlonships (including 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 lorm.
E �Asse�will be repotled on The above-identified asset has been or will be reported and ta<paid with Ihe PA Inheritance Tax
inheritance tax form ReWm filed by Ihe es�ate representative.
REV-1500. Proceetl ro Step 2 on reverse. Do nof check any other boxes.
� �
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Please sign and date the back of the form when finished.
PApT Debts and Deductions
2
Allowable deb�s and deductions mus�meet both of(he following criteria:
A. The decedent was legally responsible for payment,and the estate is insutficien�to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of paymen�if requested by the department.
Qf adtlitional space is required. you may atlach e L2"x 17"shee[s of paper.)
Date Paitl Payee Description Amount Paid
Total Enter on Line 5 of Tax Calculation) $
PART Tax Calculation
3 H ou are makin a correction to ihe establishment tlate Line 1 account balance Line 2 ,or
y g ( ) ( ) percen�Wxable(Line 3),
please obWin a written correction from ihe tinancial ins�itu�ion antl attach i�to�his form.
L Enter the da[e[he account was established or titled as it existed at the date of death.
2 Enter the�o�al balance of the account including any in�eres�accrued at�he date of dea�h.
3. Enter the percentage of ihe account that is laxable to you. _
a First,determine the percentage owned by�he tleceden�.
. Accoun�s�hat are held"in tms�for"ano�her or others were 100%owned by the decetlent.
ii. Por joint accounis established more than one year prior to ihe date of death,the percenta9e taxable is 100%divided
by�he total number of owners including[he decedent (For example:2 owners=50%, 3 owners=3333%,4 owners
=25%,etc J
b. Next,divide ihe decedenYs percentage owned by the number of surviving owners or beneticiaries.
4. The amount subjec�to tax is delermined by mul�iptying�he accoun�balance by the percen�[axable.
5. Enter�he total of any debts antl deductions claimed irom Part 2.
6. The amount taxa6le is determinetl by subirecting the debts and deductions irom ihe amount subject to tax.
7. En�er Ihe appropriate tax ra[e trom Step 1 based on your relationship to the decedent.
If indicatinq a diHerent�ax rate,please sta�e Official Use.Only ❑qnF .
yo�r reiaconsn�p m me de�ede�c pA pepartment of Revenue ' .
1. Date Established 1 �� �
2. Account ealance 2 S PA�
3. Percent Taxable 3 X � �
4. Amount Subject[o Tax 4 $ � � . . �
3
5. DeblsandDeductions 5 - Q:-.�
6. AmountTaxable 6 $ $ -� �.
7. Tax Rate 7 X fi ��
e. T� Due 8 S �
8
9. With 5% Discount (Tax x .95) 9 X
St2P 2: Si9n and date below. Return TWO completed and signed copies to Ihe Register of Wills listed on the fmnt of Ihis form,
along with a check tor 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 penalty of perjury, I declare that ihe facts I have reported above are tme,correct and complete to ihe best ot my knowledge and
belief.
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jL c.t� Home � —Z --/J
Tazpayer Signature Telephone Number Date
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-5327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-4473020