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Home My WebLink About09-16-15 (2) auxeau nr �xorv�ow� raxes Pennsylvania lnheritance Tax ' �� PennSy�Vdllld PO BOX ?Bocv ' pEPPPTMENT OF PEVENUE NRRRISBUfl6 PR ll128-0601 �nFO�mat��n N�t�Ce ypr wa�a mma ue ro And Taxpayer Response Fi�E N0.2ii5-ossa �:�i,�'..` ' � ' . � " �'` ACN 15136279 -. �� _ . DATE 07-154015 ��0�5 7L� IC i'I'� 1 JI 7ypeafAccount �Esta[e oi WILDA H OLD Savings � : . Checking � DateofDeath06-0420�5 X Tmst JANICE KENNEDY CU�� CoUnryCUMBERLAND Certi�icate 20] S 16TH ST CAMP HILL PA 1701L5514 WELLS FAk60 provided the department with the informa[ion below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment antl Forms to: AccounlNo.247412041511479 Date Established 04-26-2001 REGISTER OF WILLS Account Balance $8,869A2 � COURTHOUSE SOUARE CARLISLE PA 17013 Percent Taxable X 33.333 Amount Subject to T� $2,956.44 Tax Rate X 0.150 NOTE': If tax paymen�s are made within three months of�he Potential Tax Due $443.47 decedenYs date oi death.deduct a 5 percent discount on ihe tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months afler�he date of death. PART StOP 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. Pmceed m Sfep 2 on reverse. Do not check any ofher boxes and disregartl the amount shown abwe as Poientiai 7ax Due. g �The information is The above informa[ion is rorrect, no tletluc�ions are being taken,and payment will be sent correct. with my response. Proceed ro Step 2 on reverse. Do not check any ofher 6oxes. p �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child, grandchild,etc.)of�he deceased. (Seled correc�tax rate at righ�,and complete Part � �p� I am a sibling o(Ihe deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or tleductions The information above is incorrect and/or debis and deductions were paid. listed. Complete Part 2 and part 3 as appropriafe on fhe back ol fhis lorm. E �Asset will be reported on The above-identified asset has been or will be reporled and tax paid with the PA Inheritance Tau inheritance tax form ReWm filed by the es�ate representative. REV-1500. Proceed to Step 2 on ieverse. Do not check any other boxes. � �Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions mus�meet both o�the�ollowing criteria: A. The tlecedent was legally responsible for payment,and the estate is insuNicient to pay the deductihle items. B. Vou paid Ihe debts afler the death of the decedenl and can fumish proof of payment il requestetl by the depatlment. Qi additional space is required,you may atlach B 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paitl To�al Enter on Line 5 of Tax Calcula�ion $ PART Tax Calculation 3 Ii you are makin a correction ro the establishment dale Line 1 account balance Line 2, or 9 ( ) ( ) percent taxable(Line 3), please obtain a written correction irom ihe tinancial institution and attach it to this form. 1. Enter the da[e the account was established or titled as it existed at the date of death. 2 Enter the total balance of the account induding any interest accrued at ihe date of death. 3. Enter the percentage ot the account ihat is taxable to you. a. First,de�ermine the percentage owned by[he tleceden�. i. Accounts that are held"in trusl for"anolher or others were 100%owned by�he decedent. ii. For join�accoun�s established more lhan one year prior�o�he date of dea�h, �he percen�age tanable is 100%divided by the total number of owners including ihe decetlent. (For example:2 owners=50%,3 owners=33.33%,4 owners =25%,etc_) b. Next, divide ihe 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 Ihe total of any debts and deductions claimed imm Part 2. 6. The amount taxable is de�ermined by subtrac�ing the debts and deductions from�he amount subject b�ax. Z En[er the appropriate lax rate trom Step 1 based on your relationship to Ihe deceden�. If indicaling a diHerent tax rate,please state yourrelationshiptothedecedent � ��'��"�" "" .,i�= -. i. �ace Escabrsned i � �'A�afRer�enue . � � � = �rv � �� 2. account Balance 2 $ Pflfl ,. „� ,� .„x ..x : 3. Percent Taxable 3 X � a � r ,.�r n �: s-,.:�;. 4. Amount Subjec�to Tax 4 $ .3 t�r;,� 5. Debts and Deductions 5 - '�� ,. 4 �-a v.3s ir 6. Amoun�Tauable 6 $ � ,.:-: � Z Tax Rate 7 6 3. :: +" 8. TaxDua B $ $ ,�s.,,�. .��.„� 9. With 5%Discount(Tax x .95) 9 x � St2P 2: Sign and date below. Return TY✓O 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�o"Register of Wills,AgenC Do not send payment direcUy to ihe Department of Revenue. Under penalry of perjury, I declare that the facis I have reported above are irue,correct antl complete to the best of my knowled9e and belief. /�� Work q �j�-�/�(i1(0l�OD� Home �TI�I�I�� l�xpayer Signature T� Telephone Number DatA ' 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: 1-800-4473020