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Home My WebLink About08-26-15 (2) � BOR�,u oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � � er1r1S lvania P� B�X 28�6�1 y p y HARRISBURG PA 17128-0601 IflfOrfllat1011 NOtIC@ DEPARTMENT OF REVENUE ' ��- - � REV-3543 EX OocE%EG (OB-12J And Taxpayer Response FILE NO.21 —LS - O�l y ACN 15140218 DATE 07-28-2015 �t`�r r,�,i��,._. �. ^r i v� Q� _. _ _ ,-. , �,�1 ?.�S �`�-�•� • - Type of Account '�1� f�`�, tatp,�I�IApMI�Ea KUNTZ Savings : ,_ V 2 N f 1.-1$-4328� Checking Date of 2015 Trust JOHN C KUNTZ ��nty CUMBERLAND Certificate 302 E PORTLAND ST MECHANICSBURB PA 17055 Q�PE{n;; ' { �-n; CU�3 f�,�_ `�:_ MEMBERS isr Fcu 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. 171195 Remit Payment and Forms to: Date Established 11-05-2007 REGISTER OF WILLS Account Balance $2,180.00 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $1,090.00 Tax Rate X 0.045 Potential Tax Due $49.05 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 to Step 2 on reverse. Do not check any ofher boxes and disregard fhe amounf shown above as Potential Tax Due. g �The information is i�h�above information is correct, rio 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 � 12qo I am a sibling of the deceased. 3 on reverse.) � 15°/a All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete 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 other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 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 �alculation 3 If you are making a correction ta the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obfain a inrritfen corr�ction firom tFie f�narsiiai insti�tuiio�and aiiach ii iu i�iis 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 than 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 \\� �\�;�\\\\ \��\� �� \��`\��\�� your relationship to the decedent: � �,��;�o�� `�� \�� \�� i��C� `�� 1. Date Established 1 ` `..��\\��\\��`�\\\\\��\\\��\�\��\��o� �\ �� A.��\ \��v �� :. ��V�A ��A ��AAAA� � � ..A �� A�� `Z. ACCOUIII BbllblflC2 `L $ �� \�' � v\v v `�� A� � A �� AA�� AA� VOA: \�\ ��\\\��.��\ �\\��r � �� \\ X V A �� AA �AA �AA� p��\ 3. P@fC@(lt T8X8b�8 3 �� A\�� A�� ` ��" ��\��` �� ' �� A� �� AA \��•A � �� _ �AA � 4. Amount Sub'ect to Tax 4 $ � � �� ' � �� y�� V- �� .� �� 'VAA �� ` �� ,AV��A �� A V� � � �O� �J. �@bt$811C� �@C�UCtI0f1S �J � � �� \A �Av�� , �� ` � �� -\��\� �� \�\\\�\�\\ �� \� �\" �\ : 6. AmOUllt T1x3b12 6 $ � \�� A ��"�� ` � a ��\ �A�" �� . �� ti�� \\`�V��A\ � 7. Tax Rate 7 X � �� ;, ��: 8. Tax Due 8 $ � � � � � ` �� .��. � _ � �� '.�� ..:�\�\�\�� o�o.a� �.�\\� ��\\\ ��. \\�\..�.:: �� .�� 9. With 5% Discount(Tax x .95) 9 X �� u.....>...�A\�..:.�A�oa��e��. . .,�O�A�� p�>. ......� A..�.. �� .�..�v:A� .��....�� 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. �'e�' w,brk C 7!7) ��S- Co7�iy c/,�.. � — � Home �?�7 (.e 97� (� �/03 Ta ayer Signature �� (', �u h-�Z Telephone Number Date � iY l�� 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 BUREAU OF INDIVIDUAL TAXES Penn �a ,� ��il T$X • � p�+��`�'y��"�� PO BOX 280601 �'S^. �U �� HARRISBURG PA 17128-0601 RECy.� �at�bn f��Q�I�P�, DEPARTMENTOFREVENUE r �� --�� REV-1543 EX DocEXEC (OB-12) �S`�Fa�xpayer Resporise FILE NO.21 — �S- �(� �Q��j .��.}J� 2b �� -2 C5 DATE 07428-2015 vl_r�i�,.; . . ��r r�r �: � - ,- Type of Account �u�i c�t� �; r� Est�te of NAOMI G KUNTZ Savings SSN X Checking Date of Death 07-15-2015 Trust JOHN C KUNTZ County CUMBERLAND Certificate 302 E PORTLAND ST MECHANICSBURG PA 17055 MEMBERS isr Fcu 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. 171195 Remit Payment and Forms to: Date Established 10-03-1997 REGISTER OF WILLS Account Balance $3,255.06 1 COURTHOUSE SQUARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 1,627.53 Tax Rate X 0.045 Potential Tax Due $73.24 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 to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g �The infon-�atior� is i i��e above information is correct, no deductions are being taken,and payment wili be sei�t 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. Comp/ete 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 other boxes. Please sign and date the back of the form when finished. � v PART Debts and Deductions 2 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), ryleas�obtain a w��iiten correction froer the f:narcial institu4ion a�sti arach it t�ttois torm. 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 than 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 ,� ��\� ��\ � „ �� , � �� \�� your relationship to the decedent: � �� \\�� \ ��1'C1��.��E�� 1. Date Established 1 `� �� `� ��ti�`� ��` `�`��``�"�"��A` � � ' \��o�� A�� \�� \�� A�� `°�� A�� V�\�� \�� V�� AVA 2. Account Balance `Z $ � �`�\�� \�� \��\�\\ �\��\��\\�� VA � �AA �a\ �A��\ �� .�. P@fCeflt TclXclb�@ .� X V�� A�� o�� : ��A��c�� A��A�� A`. � ��\� ��\` �\\ �\\�� \��`� ��\\��\\ � \ 4. Amount Sub'ect to Tax 4 $ �� '� \� �\ ��A ��V ��V� � �� .A��AAVA�'� � o. VA �� A A � �� A\�� A�A �: �J. �8bt$clfld �P.dUCtlOfl$ �J 3� � �AVVA� ��o�- \ �� AA��A�� A�� . V�V� � �� \ . �� A�� V\ \ 6. Af1lOUflt T8X8I�I8 F) � +�'�� A�V�� .��A\V�A�� \ ��A��AA��A�� ; �AA�� A �� \�A��\�� A�� . \ A A� � �� VAV� � � 7. T� Rate 7 X �� ,��, �� ,�. -, ��, �� 8. Tax Due 8 $ � ��"'�`'"` � � � � � . ��. ��\\\�\. �\�\\\�\\� ��\ �\\�\ �\\� \\\.... �°..�.,.\ �V� 9. With 5% Discount(Tax x .95) 9 X ��. ._., ��.,��<.��o��,<. ��,��... ....,, � ...:� .: �� .�..,:� .�.:�� 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. (�� wtdrk ( 7J7) �3�iS- 1�79y' �it�n � - c� Home (7/7 Q�- �,3 axpayer Signatur �a i�� C. �U� �-L Telephone Number Date ��Y � — 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 �� BUREAU oF INDIVIDUAL TAXES Penns Ivania lnheritance Tax � �� ennS�/Lvania Po eox zaocoi y 1'' J HARRISBURG PA 17128-0601 IflfOrfllat1011 NOtIC@ DEPARTMENT OF REVENUE And Taxpayer Response RE°-'S"EX°°`EXE` `°B-'2' FILE NO.21 — L� � ��L.+ �iEL�i{17"� � i�� Qi ACN 15140220 � ^- �- 4 k t+� : � DATE 07-28-2015 �� R�� 26 �� Type of Account � ,, ,. Estate of NAOMI G KUNTZ Savings �� `` SSN 191-18-4328 X Checking a�?��?,' ' DaCe of 15-2015 Trust JOHN C KUNTZ �,_ ; Gounty CUMBERLAND Certificate 302 E PORTLAND ST �UMQ� MECHANICSBURG PA 17055 MEMBERS isr Fcu 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. 163260 Remit Payment and Forms to: Date Established 09-24-1997 REGISTER OF WILLS Account Balance $771.58 1 COURTHOUSE S(�UARE Percent Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $385.79 Tax Rate X 0.045 Potential Tax Due $17.3g 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. 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 not check any other boxes and disregard the amount shown above as Potentia/Tax Due. g u The information is i he above information is correct, no deciuctions 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. Comp/ete 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 '�ci'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. PART Debts and Deductions 2 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 balsnce(Line 2), or percent taxable(Line 3), �lease obtsin a wri�t�n eorreciion from the firia�cial instiiution and atf�cn it io iinis iorm. 1. Enter the date the account was established o: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 than 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 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 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 ��y�� ;��`�`a�`� �� your relationship to the decedent: � ��`��`��. �� `�, ; • �o�A�� ' � � � 1. Date Established 1 "�`�� \�`; �� `\� �\ �� `�,< �� \\\\ \\� �\� �\�� . ��A �AV ` �� `��A��A\ �A��\� � �� 2. ACCOUIIt B8I8�C2 `L � �� \\�� A� �� `�� A��A�A�A ��A� �� A� � ��\ �\�� e�� o� '�� AVAA � 3. Percent Taxable 3 X �A\ � � ��`�� o�� , �� o �� `�� y �� yAV\� �� A��A�� 4. Amount Sub'ect to Tax 4 $ �" � � �� \��\\ �� \�� ' ��\�� \�� \ � : 5. Debt$and Deduction$ 5 �� A � � � � �VA ��A\��A�� o� �� . . � � �\�A �� \\ 6. Amount Taxable 6 $ �� `�� A�A� �� _ A� , � �� i� ��ti� ��\� �� AA\ � � �� ` �� 7. Tax Rate 7 X � �= � �� 8. T3X �U8 $ $ ��V�� , � �� \� � � �� +� � V�� \ ��A`��\�� A�� 9. With 5% Discount(Tax x .95) 9 X ,,.;�,�a,�� ............, ,..�._.: .._.... ......: ��.�......._i�.��.....�A��..��a...A��.:, A ,...,..:.�� 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. /��I Wjdrk (71�) o3y,S- Ce 7�1�/ a� �- —� :szc�� Home � 7 G�- Oy3 xpayer Signature �� C. �ui��Z Telephone Number Date g�jy/`s�— 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 LAW OFFICES Purcell, Krug � Haller HOWARDB.KRUG 1719 NORTH FRONT STREET HERSHEY LEONP.HALLER HARRISBURG, PENNSYLVAN[A 17102-2392 (�I�) 533-3836 JOHNW.PURCELLJR. TELEPHONE (717) 234-4178 Jit� M. W�NE[cn FnX (717) 783-4939 �oNN w. PUacer,L�i9za-zoo9> L[SA A.RYNARD JOSBPH NISSLEY (1910-1982) August 24, 2015 Register of Wills Cumberland County Court House One Courthouse Square Carlisle, PA 17013 Re: Estate of Naomi G. Kuntz No. 21-15-0814 Dear Register of Wills: Enclosed please find three originals of Revenue Form 1543, Pennsylvania lnheritance Tax Information Notice And Taxpayer Response for each of the two separate joint checking accounts and one joint savings account co-owned by the Decedent, Naomi G. Kuntz and her son, John C. Kuntz. Please return a date-stamped copy of each document to me in the enclosed stamped, self-addressed envelope. Thank you. Sincerely, . �. ' I M. Wineka JMW/bas Enclosures cc: John C. Kuntz, Exec. w/o enc. � x a � V � � � � z 9 : c n � � . �u � a z o , � G N n • o � � � . N M N � W � CD N `' O ♦J N '�" � � � � = � 3 cQ _ _mom � � = � D � � o o � � �,� � t"� � c�n n = �� o cn = cn �. w� � � � n �r, i? � � �Yi � �'•1 _ �r.} � �� 3 (p •r4 _ 1 Tz .�• ��. �' . F { ��. ..��. �.��J� !:r:t...: O p N C O N� � C/3 w�v ` � `fl �� OO co o � y N � n �A m � � � � N Z � �. m �/� < N \,y � O O � � p m �