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Home My WebLink About08-06-15 COmMOrvw�irv OF c_m�.V'vLVnrv'.a qEV-0 l62 EXI l l-�J01 NTOF pEVE1JE BVPbW OF IN�IVI�OAL'wxc5 OEO� 1 PPPISPJ'+G,vp 1]122�060� PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 021076 BAKSI SANDRA M 371 BOBCAT ROAD NEWVILLE, PA 17241 ACN ASSESSMENT AMOUNT CONTROL NUMBER 15131801 516.94 ESTATE WFORMATION: ssn�: 15131802 $250.25 FILE NUMBER: 2715-0712 DECEDENT NAME: BAKSI DOLORES DATEOFPAVMENT: 08/06/2015 I POSTMARK DATE: OS/03/2015 COUNTV: CUMBERLAND � DATE OF DEATH: 03/OJ/ZO15 � TOTAL AMOUNT PAID: 5267.19 REMARKS: RECEIPT TO ATTY CHECKti1335 INITIALS: CJ sen� RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS FEGISTER OF WILLS 9VRFFp DF iNUIVIpWL iq%ES P� aox =aoso� Pennsylvania lnheritance Tax . � -r pennsylvania HARRISBORG PP V12B-0601 � . I�f0�m2ti0nNotiCB ' oevnerneruroraevervue And Taxpayer Response "" "^_"°°�• �° -�_, RECO?D:_^ �=��I;c OF Fi�eNo. zi -i`i -�..�� ,Z REG!^.--;-�- � ACNisiaiaoi DATE 06-12-2015 2015 RUG 6 Ff7 12 4y Type of Account C�: . Estate of DOLORES BAK51 QRP � Savings SANORA M BqKSI � � Date of Death 03-09-2015 CheCking 371 BOB CAT R� CUM�[ � � �� . CounryCUMBERLAND Tmst NEWVILLE Pq 17241-9725 � Cerlificate s a T BANK provided [he department with the information below indicating that a[the death of the above-named decedent you were a joint owner or beneficiary of the account identified. AccountNo.201050561 AemitPaymentand Formsto: Date Establishetl 03-0&2017 Account Balance REGISTER OF WILLS PercentTaxable X503.03 CARLISLE PAS7 003ARE Amoun�Subject�o Tax $376.52 Taz Rate X 0.045 Potential Tae Due $�g yq NOTE': I�tae paymenis are made within three months of the With 5%Discount(Tax x 0.95) $(see NOTE'� decedenYs date of death, deduct a 5 percent discount on[he�ax due. Any inheritance tax due will become tlelinquent nine months afler Ihe date of death. PART StBp 1 : please check the a p i ppro riate boxes below. A �No tax is due. I I am the spouse of the deceased or I am the parent of a decedent who was 27 years old or younger at date of death. Proceed to Sfep 2 on reverse. Do no[check any ofher boxes and disregard fhe amount shown above as Potenhal Tax Due. B ❑The information is The above information is correct, no deductions are being taken,and payment will be sen( wrrect. with my response. Proceed to Step 2 on reverse. Do not check any ofhei boxes. C ❑The tax rete is incorrect �q,5% I am a lineal beneFicia (Select correct tax rate ai ry(parent, child, 9rantichild, etc.)o�the deceasetl. right,and wmplete Patl � �p� I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(induding none). p ❑Changes or deductions The in�ormation above is incorrec(and/or tlebts and deductions were paid. listed. Complete Part 2 and art 3 as P appropriate on the back ol this/oim. E ❑Asset will be reported on The above-identified asset has been or will be repotletl and tax paitl with the PA Inheritan� inheritance tax form Retum filed by the estate representative. � REV-1500. ProceedtoStep2onreverse. Donotcheckanyotherboxes. Please sign and date Ihe back of the form when finished. � — .r I Debts and Deductions Al�able debts and detluctions must meet both of the^�o^i[ a'nd theeestate is insufllcient to pay the deductible items. q. The tlecedent was le9ally responsi6le for pay g. You paid the debts after the death of the decedent and can furnish pmof of payment if requested by the department. Qf additional space is required,you may attach 8 1/2'x 11'sheets of paper.) Date Paid Payee Descripiion Amounl Paid Total En�er on Line 5 05 Tax Calculation $ r PARr Tax Calculation I 3 p you are making a cortection lo the eslablishmem date(Line 1)account balance(Line 2L or percent tazable(Line 3), please obtain a wdtten eorrectlon irom[he finaneial inslitution and attsch it to ihis torm. L Enter Ihe date�he account was establlshed or litled as it ezisted al ihe date of death. 2 Enter the total balance of the account including any interest accmetl at the date of death. 3. Enter the percentage of the account that is taxa6le to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in tmsl for"another or o[hers were 100%owned by[he decedenl. 'li. py`the tolal number of owne s inolud ng the decedenL r�Forhexample 2 owne se P50%n3 ownersbl 3333�/4 o ne�rs =25%,etc.) b. Nexl,divide Ihe decedenYs percenla9e owned by the number of survivinq owners or bene�iciaries. a. The amount sublect to tax Is deiermined hy mWtiptying the account balance by ihe percent taxable. 5. Enter the total of any debts and deductions claimed fmm Part 2. 6. The amount taxable�s determined by subtracting the debts and deductions from the amount sub7ect lo tax 7. Enter the appmpriate tax rate from Step 1 based on your relalionsh�ip to[he deced�� If indicating a different tax rate,please state �� g �,.;� : �; t s�� your rela�ionship�o the decedenL ' , « �'� ,�.,n.« � ,� x �,��'� :n + �. DaleEslablished � �. �. _ : a �"�' ^ ! 2. Account Balance Z $ �:� � � 4 -�^�"_'f �,'M•--�`� 3 X 'L"�; 's"_r* ' �, , -.^'-- 3. Percent Taxable � . �'.� f �� ' . _ 4. Amount Subject to Tax 4 $ 3�,�� '� �� ^�'—� _a,r �� 5 - ��' �s'' ' r � i � g. �ebts antl Deduclions �x;, _-�-==--------=� �, 6 $ �� " • �' `��-'---'-�{-"" 6. Amount Taxable ('y �: , ;�. �„�'�" . X v,fi�, ✓�u ° .� 7, Tax Rate � � � , t # ,�. -��:`�, �` ,� '?-'�' r � g Tax Due e $ � � � g W th 5/ D s ounl(1 95) 9 X �ry ys,jo g�w'd?achleckforanypaymentyo,uareTmaOking. Checksmus9bedmadepayableloe9Regis[eroflWillseAge th Donotsendfom payment direcUy to the Department of Revenue. Under penalry of perjury, I declare ihat the facts I have reported above are true,correct and complele to the best of my knowledge and belief. Wo�k � j � 7 � �� `� � / „/�. Home Ta � yer Slgnature Telephone Number Date DIS RCT OFFICEROR THESINHERTANC�ENTAXTDIVSONLATN77-87g32MENS RVICESEFOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-4473020 auxenu o� �Homoun� raxes Penns Wania lnheritance Tax "`�� enns lvania PO BOX 200601 Y �- P Y HPRRISBIIRG PA V109-0601 Information Notice OEPqqTMENTOFqEVENUE And T�payer Response �°-"`_ `�°.`�"'"°."' RECORDED O�=FiC-E OF F1LeNO. 21-15-z:�� . RE�I��r=- - - ncNisia�ao2 � �"-1_S DATE06-1&2015 %715 AUG 6 F�I 1p �y Type of Account C I , " Estate of DOLORES BAKSI �Savings �RPry . .. Checking Date of Death�3-09-2015 Trust SANORA M BAKSI CUMDCh� ' � CountyCUMBERLAND X CertifiCate 371 808 CAT RD ' NEWVILLE PA 17241-9725 s s T BANK provided the department with the information below indicating that at ihe dea[h of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.2001050314 Remit Payment antl Forms to: Date Established 0406-20t1 REGISTEH OF WILLS AccountBalance $ 11,722.pg 1COUR7HOUSES�UARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tau $5,561.04 Tax Rate X 0.045 Po�ential Tav Due $25025 NOTE': It fax paymen�s are made within Ihree months of Ihe With 5%Discount Tax x 0.95 decedenYs date of death, deduct a 5 percent discount on the tax ( ) $(see NOTE') due. Any inheritance�ax due will become delinquent nine monihs after ihe date of death. PART $te 1 : Please check [he a p � P ppro riate 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 ro Srep 2 on reverse. Oo not check any other boxes and disregard the amount shown above as Potential Tar Due. g �The inbrma�ion is The above information is wrrect, no deduc�ions are being�aken,antl paymen�will be sent correct. with my response. Proceed to Step 2 on reverse. Do nof check any other boxes. C �The tax rate is incorrecL �4.5% I am a lineal beneficiary (parent,child,grandchild, etc.) of the deceased. (Seleciwrrecttax re�e at right, and complete Part � �p� I am a sibling of ihe deceased. 3 on reverse.) . � 75% All other relationships(including none�. p �Changes or deductions I The information above is incorrect and/or debts and deductions were paid. listed. Comple(e Part 2 and part 3 as appropnate on the back ol this lorm. E ❑Asset will be reportetl on The above-identified asset has been or will be reported antl tax paid with the PA Inheritance Tax inheri[ance tax(orm ReWrn filed by the estate representative. REV4 500. 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 Allowable debis and deductions must meet both of the tollowin9 criteria'. A. The decedent was legally responsible for payment,and the estate Is insufficient to pay the deductihle items. B. You paid the debts after ihe death of the decedent and can Wmish proof of payment if requested by the tleparlment. Q�additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Llne 6 of Tax Calculation) $ PART Tax Calculation 3 If you are making a correction ro the establishment tlate(Line 1)account balance(Line 2),or percent laxable(Line 3), _ plca:e oblain a written oorrectlon iram the firencial instilution antl attaeh it ta th�s lorm. L Enter the date the accoum was established or titled as it existed at the date of deaih. 2 En�er lhe�otal balance of Ihe account includin9 any interes�accrued a�the date of death. 3. Enter the percentage of the account that is t�able to you. a. First,tletermine[he percentage owned by the decedent. i. Accounts ihat are held"in tmsl tor"another or others were 100%owned by lhe decedent. ii. byrthe total�umber o�olwners nclud g me decedent (Forhexampler 2 owne s�=P50%n3 ownersb 33.33�/4 owners = 25/.etc) 6. Nex�,divide ihe tlecedenCs percenta9e owned by the number of surviving owners or beneficiaries. 4. The amount subject�o lae is determined by muHiplying lhe accou��balance by the percen�taxable. 5. Enter�he total of any debts and deductions claimed from Parl 2. 6. The amount laxable is delermined by subtrac�ing the deb[s and deduclions from the amount subjecl b tax. Z Enter ihe appropriate tax rate from Step 1 based on your relationship to the decedent If lndlcating a dlfferent tex rata,please state � �y�+��Y��a�" � , your rela�ionship to the decedent: � . �S kmp211tA1e1}}.�R��7�� 1. Date Established � ' '"�„��°�°t� ` � `-'� N� � '� �f,4 �;� 3 2. Accoun� Balance 2 $ t� 7 - 3. Percent Taxable 3 x � -,� g, 4. Amount Sublect to Tax 4 $ 3 � 2�x 5. Debls and Deductions 5 - `� �+�,.i „ �� 6. AmountTaxable 6 $ S. .: � �, 7. 7� Rate � X a 's"� � g. Tax Due 8 $ I$ � "� g W th 5/ D sco n[(T 95) 9 x StQP 2: Sign and date below. Retum 74Y0 completed and signed copies to the Register ot Wills listed on the front of this form. along with a check for any payment you are making. Checks must be made payable to"Re9isler of Wills,AgenC' Do not send payment directly to the Department of Revenue. Under penalry of perjury, I dedare that the facts I have reported above are true,correct and complete�o ihe bes[of my knowled9e an belief. � � WOfk �Y/i�'l�iQ� �� Nome � 17�7 ' `�l�lG� ��lS /S Taxpay�t Signature Telephone Number Date IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENU� TAX AIYER3 WITH SPECIAL HEARINGIAND/OR SPEAKING O EDS ON Y?$800 447-30 ORVICES FOI ;OftDFD O�FICE OF �� m � y _GIST�.. . _ ,.�,�1_LS F � � o Q AUG 6 Fi� 12 `,y D � � � _ c�:_ � a _. ti ORPH/.�':'_:;' :... - a UMBEF.I.' ��'-� . � j '�^ i�i � v.) ii � �_� � � �'7 i(7 iii � lf! � �� = � � �/ ssr� � � fr _ �, ' � �. - x' :� = r.. _ N - " :I J 4��/ � = f )��r = 1 1 3 \j � - E{ f�� f /� a,,� fi ( � � � � �: �