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HomeMy WebLinkAbout07-31-15 (4) t BUREAU OF INDIVIDUAL TAXES Pennsylvania Inheritance Tax ' �'` pennSyLVanla .PO BOX 280601 Y HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE "--_ � REV-1543 EX DocEXEC (OB-12) And Taxpayer Response FILE N0.21 - 15 -10 ' . ACN 15132668 DATE 06-18-2015 f Type of Account Estate of HAROLD L NORTH Savings SSN X Checking Date of Death 06-01-2015 Trust KATHLEEN E RUEGG County CUMBERLAND Certificate 57 LONGS GAP RD CARLISLE PA 17013-1218 70 C_ 1 !--► CJ -73 SUSQUEHANNA BANK provided the department with the information below indicating4hat at€fes dent 'pf the above-named decedent you were a joint owner or beneficiary of the account idekitified. � o Account No. 1583523020 Remit Payment and Forms to: Date Established 11-23-2011 REGISTER OF WILLS Account Balance $47,494.15 1;COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $23,747.08 Tax Rate X 0.150 Potential Tax Due $ 0.150 06 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 1 Step 1 : Please check the appropriate boxes below. 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 F1 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. I C The tax rate is incorrect. 4.5%o I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part 129/6' 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. « - Y � � � Debts and Deductions Allowable debts and deductions must meet both ofthe following uriteria ^ A. The decedent was legally responsible for payment,and the estate isinsufficient topay 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 iarequired,you may attach 81x11^sheets ofpaporj � Date Paid Payee Description Amount Paid Total (Enter on Line 5Jbf Tax Calculation) $ PART -[ax Calculation Ifyou are making acorrection hothe establishment date (Line 2),nrpercent taxable(Line 3), please obtain a written correction from the financial institution and attach itbmthis form. 1. Enter the date the account was established ortitled aabexisted o1the date ofdeath. 2. Enter the total balance ofthe account including any interest accrued at the date ofdeath. 3. Enter the percentage ofthe account that iotaxable Vnyou. i -a. First, determine the percentage owned bythe decedent. . i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. '. ii For established more than one year prior 0othe date ofdeath,the percentagetaxable ia1UU%divided bythe total number ofowners including the decedent. (For example:2owners=5O%' 3owners=33.33%,4owners ~25%.eto.) ' b. Next,divide the decedent's percentage owned bythe number of surviving owners mbeneficiaries. 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 Ntax. Y. Enter the appropriate tax rate from Step 1 based onyour relationship buthe decedent. If indicating a different tax rate,please state your relationship to the decedent: Nn 2. Account Balance 2 $ 3. Percent Taxable 3 X NO, 4. Amount Sub ect to Tax 4 $ 5. Debts and Deductions a T, va *41 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 nof send payment directly to the Department of Revenue. I under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and ~~