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HomeMy WebLinkAbout08-17-15 (6) BUREAU OF INDIVIDUAL TAXES PennInheritance Tax pennsylvania PO BOX 280601HARRISBURG PA 17128-0601 R E C 0 R D F D 0 F R UnMon Notice DEPARTMENT OF REVENUE R E G I STI" � P, �nd,,ij; 4 er Response FILE NO.2115-0730 AGN 15138162 ISI' ? 24 DATE 07-14-2015 Type of Account Estate of LULU C CHAMBERS. Savings C 0 M D F :i_ .,`, % SSN Checking Date of Death 05-28-2015 X Trust RONALD A CHAMBERS County CUMBERLAND Certificate 2632 ROCKLAND RD MC ALISTERVILLE PA 17049-8243 S & T BANK provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.201036546 Remit Payment and Farms to: Date Established 05-07-2015 REGISTER OF WILLS Account Balance $.66,640.32 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $33,320.16 Tax Rate X 0.045 Potential Tax Due $1,499.41 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 Step 1; please check the appropriate boxes below. 1 A ❑No tax is due. E am the spouse of the deceased or 1 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 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% 1 am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate at right,and complete Part 12% 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 fKA Asset will be reported on The above•ldentlfied asset has been or will be reported and tax paid with the PA Inherltanee 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. P RT Debts and Deductions Allowable debts and deductions must meet both dthe following criteria: A. The decedent was legally responsible for payment,and the estate isinsufficient&npay 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 I I"sheets of paper.) Date Paid Payne Domohpdnn Amount Paid Total(Enter on Line 5 of Tax Calculation) $ PART Tax Calculation �--� If you are making correction tmthe establishment date orpercent taxable(Line 3). please obtain awritten correction from the financial"institution and attach,^"=this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the totalbalance ofthe account including any interest accrued o¢the date ofdeath. 3. Enter the percentage o/the account that istaxable toyou. o. First,determine the percentage owned bythe decedent. i Accounts that are held"intrust for'another or others were 100%owned by the decedent. |i. For established more than one year prior tothe date ofdeath,the percentage taxable ia180%divided bythe total number ofowners including the decedent. (For example:2owners~5OY6.0owners=33.33%.4owners ~25Y6.etr.) b. Next,divide the decedent's 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 ufany debts and deductions claimed from Part 2. O. The amount taxable is determined by subtracting the debts and deductions from the amount subject 1otax. 7. Enter the appropriate tax rate from Step 1 based onyour relationship Uothe decedent. If indicating a different tax rate,please state your relationship to the decedent: 2Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 t, .-M n Amount Taxable m 7. Tax Rate 7 X Step 2^ date below. Return.TWO completed and signed copies to the Register of Wills listed on the front o[this fonn, along with ocheck for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly tothe Department ofRevenue. Under penalty ofperjury, |declare that the facts |have reported above are true,correct a nd complete to the best ofmykn dge and belief. VVOrh Home � Taxpayer Signature Telephone Number u@I8IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT Or- 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 ' ' - '