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Home My WebLink About08-04-15 �2'1 .� a�a�� oF ,�o��A� �•*Fs Pennsylvania lnheritance Tax �� Pennsylvania PO BO% 30060t OEPAPTMENi OF HEVENOE N>RR6BIIR6 PF 1]12B�0601 �n'D�ma��On NQt�Ce ve un[�mmec ree-izi And TaxpaXer Response - RECORD��.�� _�FF!CE Ot Fi�EN0.2i—�5_�;�yg ACN t5139380 FEG�;T -�' �� !i'!_LS onTeo�-zz-zou �� '� � �.� �i �� TypeofAccoun� (,� �„ Es�ate oNERNON A HOOVEF �Savings QRPF� ,,�. _ cneck�n9 Date a�Death 09-2b2014 Tms� MARIE E HOOVER ��MBr �L�"� � � , ��;� CountyCUMBEFLAND Cehifica�e 45 GALE RD CAMP HILL PA 17011-2624 SANTANDER BANK provided the depariment with the intormation below indicating tha[at the death of the above-named decedent you were a joint owner or beneficiary o(the account identified. Remit Payment antl Forms to: AccountNo. 1054018047 Date Estabiishetl 12-04-1990 REGISTER OF WILLS Account Balance $5.Oa4.62 � COURTHOUSE SOUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subjecl[o Tan $2,522.31 Tax Rate X 0.150 Potential Tax Due $378.35 NOTE': If tax payments are matle within three months of ihe decedenYs date of death, deduct a 5 percent discount on the tax Wi[h 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine monihs afterthe date ofdeath. PART $t2p 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. Proceetl to Sfep 2 on reverse. Do not check any other boxes antl tlisregard the amount shown above as✓otent�ai !ax Uue. g �The intormation is The above informa[ion is correct, no tleductions are being taken, antl payment will be sent correct. with my response. Proceed to Sfep 2 on ieverse. Do not check any other boxes. � �The�ax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild, etc.)of�he deceased. (Selec�correct�ax rate a� right,antl complete 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 paitl. listed Complete Part 2 and part 3 as appropnate on the back ol this lorm. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance t�form Rewm filed by ihe estate representative. REV-1500. Proceed ro Step 2 on reverse. Do not check any other boxes. � Please sign and date Ihe back of the form when finished. PART 2 Debts and Deductions Allowa6le debts antl tleducfions must meet both of Ihe following criteria: A. The decedent was le9ally responsible for payment, and Ihe estate is insuNicient to pay the detlucti6le items. B. You paid the debts afler the dea[h of[he decedent and can furnish proof of payment if requested by the department. Qi additional space is required,you may attach 8 V2"x 71"sheets of paper.) Date Paid Payee Description Amoun� Paid To�al Enter on Line 5 oi Tax Calculation $ PART Tax Calculation 3 N you are making a correction to the establishment date(Line 1)account balance(Line 2�,or percent tazable(Line 3�, please obtain a written correction from the tinancial institution antl attach it to this form. L Enter ihe date the account was established or titled as it existed at the date oi death. 2 Enter ihe total balance of the account inclu0ing any interest accmed at the date of death. 3. En[er the percenta9e of the account that is taxable to you. a First,determine the percentage ownetl by the decedent. i. Accounts that are held"in Irust for"another or others were 100%owned by the decedent. ii. For joint accounis estabiished more than one year prior to the date of death,the percentage[axable is 100%divided by[he total number o�owners including�he decedenL (For example:2 owners=5�%,3 owners=33.33%,4 owners =25%,etc.) b. Nex[,divide ihe decetlenTs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by ihe percent taxable. 5. Enter[he total o�any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subiracting ihe debts and deductions from the amount subject to tax. 7. Enter Ihe appropriate tax rate from S[ep 1 6asetl on your relationship to the decedent. If indicating a different tax rate,please state �q� �JS81,)tlly Oq(� yourrelationshiptothedecedenC �AQ�a�{mQ�O{��/e�WQ �j 1. Date Established 1 2 AccountBalance 2 $ Pl1�� 3. Percen�Taxable 3 X � 4. Amount Sublect to Tax 4 $ 2 3 5. Debis and Deductions 5 - q 6. AmountTaxa6le 6 $ S: 7. Tax Rate 7 X 6�'�� 8. T� Due e $ 8 9. With 5%Dlscount(Tax x .95) 9 X St2P 2: Sign and date below. Return TWO completed and signed copies to ihe Register of WJIs listed on ihe front ot ihis form, along wi�h a check for any payment you are making. Checks mus�be made payable to"Fegis�er of Wills,AgenL Do not send payment directly�o ihe Department of Revenue. Under penalty of perjury, I declare that[he facts I have reported above are hue,correct and complete to Ihe best of my knowledge and belief. ,/ Work � � ° � l�" %. i� :-� F%�; w. _ Home Tazpayer Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 \'� 1 . � ��` � " �� i` = N � U 1-r T ��O �� v . � N ` ',Zf = `��N ° -. \%n - _ �' , � \ ��a r ^ �yl � x ';„ v n w. � W �; �`� u� t�1 A `�. S ,c .o� ° r� c - : > v� �c : � �ll �' - � o � '�n ' ��) � ✓ � '�. 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