The URL can be used to link to this page

Home My WebLink About08-07-15 �. �� BUREAU oF INDIVIDUAL TAXES Pennsylvania lnheritance Tax � • � pennsylvania PO BOX 280601 DEPARTMENT OFREVENUE HARRISBURG PA 17128-0601 �nf�rmat��n N�t�Ce ,,,,.....�� REV-I543 EX OocEXEG (OB-12) And Taxpayer Response FILE NO.21 �/.''j ��7 ACN 15138792 DATE 07-17-2015 Type of Account Estate of LOUIS J ALFERY Savings SSN X Checking Date of Death 03-14-2015 Trust KATHERINE M NEDROW County CUMBERLAND Certificate 49 W SIMPSON ST MECHANICSBURG PA 17055-6323 ,v � � c' � �, �.,.rn � � :� rnr' � � b � � � ;�1 � �'a _..; � _ _ _. .. _ __ �:7 y.,, C"" � ,N t�i j.__ --•. ��y l —�l ;:':: � . _ . , , C7 �. " _'U t `,-1 _� PSEcu provided the department with the information below indicating that at the death�sfi t�re � �' above-named decedent you were a joint owner or beneficiary of the account identifie�i..LL; ►� r-- �i Remit Payment and Forms to: ;" `�' � � o Account No. 194280841 Date Established 08-15-1976 REGISTER OF WILLS Account Balance $3,413.82 1 COURTHOUSE S�UARE CARLISLE PA 17013 Percent Taxable X 16.667 Amount Subject to Tax $568.98 Tax Rate X 0.045 Potential Tax Due $25.60 NOTE": If tax payments are made within three months of the decedenYs 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 Step 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. Proceed fo Step 2 on reverse. Do nof check any other boxes and disregard the amount shown above as Potential Tax Due. g u 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. C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (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 of this form. 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 tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any ofher boxes. \ L ` �� Please sign and date the back of the form when finished. � PART 2 Debts and Deductions Allowable debts 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. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. - (If additional space is required, you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation __ 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), piease obtain a written correction from the financiai institution and a�tach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held "in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more thar� one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%, 4 owners =25%, etc.) b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 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 to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state �� \�� ,A your relationship to the decedent: � ,�� , , � „ �� 1. Date Established �` � �� °�� 1 ° � �� `��`��•�� \� �� _ �� @ ��\\\�\\��,\\�\ �\\ � � �� \ \��\�� \�- \\\ �\\\� ��..;�� 2. Account Balance � 2 �P ��\V O\A�� V��A�� A�� AAA � �\VA � =�� \A�� .A��A A�A� A � VA� A �� V � \ 3. Percent Taxable 3 X ,�� \�� A�� `�� D� � .�. �� \ \ 4. Amount Subject to Tax 4 $ � � � �� A\V � �� \�� . A 5. Debts and Deductions 5 - � ;� �� A\A �VA � �� ` ,A\ 6. ARlOUflt T3X8b�@ 6 $ �� \ �� 7. Tax Rate 7 X �\� \ � \�� . .�� \`� � � � � 8. Tax Due g $ � � � �� \VA�� 9. With 5% Discount(Tax x .95) 9 X � � ` � �.�� ....:.::�� .,�.�.�....: ��.. .y�._. � ..... � .... ....... .__. ...> �� ...�......�.��.� 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 not send payment directly to the Department of Revenue. 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 belief. Work ��7- 7�7-�3/�/ Home 7/7- 79G�6v.3� �s i� Taxpayer 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 ,v Register of Wills � c� � � rn 1 Courthouse Square � � � � � Cariisle, PA 17013 � z' �, � �-" � ;:� ;; r- ..,, ca ri � ;.,_ �� --•] _, �� File No. 21 : : �:� ACN 15138792 •� ;' �� _ � .,�- -�..'� � � ►-� r' rn To Whom It May Concern: � `— o , s � � , .� My father Louis J. Alfery passed away on March 14, 2015. He died from a long battle of colon cancer. When he found out he had colon cancer, he had my name put on his checking account with PSECU so that I would be able to write out checks for my mother upon his passing. We closed the account and opened another checking account for my mother, transferring the money from one bank to the next. I did not inherit any money, just more responsibility. We used his checking account to pay for his funeral which I have enclosed a copy of payment. Please let me know if this is sufficed and if I need to do anything else to clear up this matter. Thank you. Katherine Nedrow 49 West Simpson Street Mechanicsburg, PA 17055 717-460-1526 �'�fal.�e;,.;,i Fune��al Hos�Te 8 Market Piaza Way (717) 697-4696 Mechanicsburg,PA 170�5 wwv��.MalpezziFuneralHome.com Michael J.Malpezzi,Owner,FD 3erem��d.Shartzer,FD Kyle C.Knipe,FD Ian J.McCreary,FD August 3, 2015 Katherine M Nedrow 49 West Simpson Street Mechanicsburg,PA 17055 This is the final statement for the funeral services of Louis Joseph Alfery We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way. PROFESSIONAL SERVICES: Services ofFuneral DirectoriSrafi $5,760.00 FUNERAL HOME SERVICE CHARGES $5,760.00 SELECTED MERCHANDISE: 18 Gauee Steel Casket $�,295.00 Senfinel Vault �1,450.00 Heaven's Embrace Register Packaae $19�.00 Rosaries $I 43.00 THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE THAT YOU HAVE SELECTED $10,843.00 CASH ADVANCES: At the time funeral arrangements were made, we advanced certain payments to others as an accomodation. The following is an accounting of those charges. Cemetery Equipment $210.00 Certified Death Certificates $36.00 Newspaper Notices-Patriot $433.58 Newspaper Notices-Pittsburgh $464.00 Clergy/Mass Offering $150.00 Organist $125.00 SoloisUCantor $75.00 Military Honor Guard $50.00 Flowers $159.00 Altar Servers $30.00 TOT�L CASH ADVANCES AND SPECIAL CHARGES 51,732.58 CONTRACT PRICE $12,575.58 HISTORY': 04/06/2015 Payment Payment $12,432.58 07/08/2015 Payment Katherine Nedrow $143.00 TOTAL AMOUNT DUE $0.00 If you have any questions or concerns regarding this bill,please call our office at(717)697-4696. "v REGdtiU�^ n - > �E�r,� �� ,� F ��,�� ?QI5 �UG 7 p�� 1 ��` '� ' � � ; c� _ - �=� - ; � �" � fiPP1 F p � ;,, a ,nr,�, � �, ��i;t f � CU��SE�� t' ,3� ,.,. �..� ��•� F�• �z� {,� (x,i � s ii � 4�.� tt) tt) , , . .�-: � � � � . ;� � _ i � � � _ c � �=� °�: r; v (,� 4-� ,:f .._ ,�," � �� ly; s.� � ,,� �• _ f� � _ � m � �. g » �