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HomeMy WebLinkAbout06-25-05 C'c;)J c;:::: (\.i ~. c; ~~g d- nV ::5~ (<vi' -"'C)VJ ;;:>:.-r ,..,-,.,,'" . ~ \' ..-' ~ o ~ ~D-x:) gJ~~ ~ <::5'" (p ~~ 0; o 0- , ~ 0 ~ -n p S' ~ ~ ~-=c 2 ~ ~ ~ ,.-- " ~i~) v:~ ~ o S ~ , ........~~....,.../ ""... .~ .v COMMONWEALTH OF PENNSYLVANIA , DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 '* INFORMATXON NOTICE AND TAXPAYER RESPONSE FILE ACN DATE I I . \\.{> I NO. 210S -()5Lll?}) 05126373 06-09-2005 REY-1545 EX AFP (D9-DDl EST. OF JOSEPH M VERBOS ~.S. NO. 179-30-3694 DATE OF DEATH 03-09-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [Xl CHECKING D TRUST D CERTIF . KAREN ECKERT 216 CLARK ST LEMOYNE PA 17043 REMIT PAYMENT AND FORMS TO: RESISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has prDvided the Department with the infDrllatiDn listed belDw which has been used in calculating the pDtential tax due. Their recDrds indicate that at the death Df the abDve decedent, YDU were a jDint Dwner/beneficiary Df this aCCDunt. If YDU feel this infDrmatiDn is incDrrect, please Dbtain written cDrrectiDn frDII the financial institutiDn, attach a CDpy tD this fDrll and return it tD the abDve address. This aeCDunt is taxable in accDrdanee with the Inheritance Ta~ Laws Df the CDlIlIDnwealth of Penn~ylvania. Quostions may bB answered by calling !717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0571108008 Date 05-19-1998 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 4,023.16 16.667 670.54 .15 100.58 TAXPAYER RESPONSE TD insure prDper credit tD YDur accDunt, tWD (Z) cDpies Df this nDtice IIUSt aCCDmpany YDur paYllent tD the Register Df Wills. Make check payable tD: "Register Df Wills, Agent". x -~ NOTE: If tax payments are lIade within three (3) mDnths Df the decedent's date Df death, YDU may deduct a 5X discDunt Df the tax due. Any inheritance tax due will beCDlle delinquent nine (9) mDnths after the date Df death. Tax PART [!] [CHECK ] ONE BLOCK ONLY A. D The abDve infDrllatiDn and tax due is CDrrect. 1. YDU lIay chDDse tD rellit paYllent tD the Register Df Wills with tWD cDpies Df this nDtice tD Dbtain a discDunt Dr aVDid interest, Dr YDU lIay check bDx "A" and return this nDtice tD the Register Df Wills and an Dfficial assessment will be issued by the PA Department Df Revenue. B. D The abDve asset has been Dr will be repDrted and tax paid with the Pennsylvania Inheritance Tax return tD be filed by the decedent's representative. C. ~The abDve infDrmatiDn is incDrrect and/Dr debts and deductiDns were paid by YDU. ~ YDU must cDmplete PART ~ and/Dr PART ~ belDw. PART If you indicate a different tax ra~~~l:ase state your @] relationship to decedent: ()..G. u. ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS L.r~!E 1- Date Established 1 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 S. Debts and Deductions S 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART [!] DATE PAID PAYEE x 4()~~<i~ \ lo. \0<01 v'}:>Sj lDlo s't y.s "'0 3o.llc DEBTS AND DEDUCTIONS CLAIMED x DESCRIPTION AMOUNT PAID \7 I TOTAL (Enter on Line S of Tax Computation) perjury, I declare that the facts I my knowledge and belief. I $ HOME ~ DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. s. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-ls48 EX) upon receipt of the return from the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one COpy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-ls48 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (MM) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 16.7X (TAXABLE FOR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 (SURVIVORS) = .50 X 100 SOX (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line 2) by the percent taxable (line 3). s. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. MThe tax rate 1mposed on the net value of transfers from a deceased Ch11d twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OX. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Date of Death Spouse Lineal Sibling Collateral 07/01194 to 12/31/94 3X 6X 15X 15X 01/01/95 to 06/30/00 OX 6X 15X 15X 07/01100 to present OX 4,5X. 12X 15X CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 1/2" x 11". Proof of payment may be requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 KAREN ECKERT 216 CLARK ST LEMOYNE PA 17043 *' !'\ ~, i,\ -I)') NO. 21 ()565L\;:A \,(1) 05126375 06-09-2005 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE REY-1545 EX AFP 109-001 EST. OF JOSEPHM VERBOS S.S. NO. 179-30-3694 DAIf'E DFl)EATH 03-09-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [Xl CHECKING D TRUST D CERTIF. REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the inforllation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this inforllation is incorrect, please obtain written correction froll the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the COllmonwealth of Pennsylvania. Questions may be answered by cQlling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0571106935 Date 05-19-1998 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due Tax PART [!] To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x 50,909.31 16.667 8,485.05 .15 1,272.76 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent.s date of death, you may deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. x [CHECK ] ONE BLOCK ONLY A. [] The above inforllation and tax due is correct. 1. You may choose to rellit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessllent will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. C. ~The above information is incorrect and/or debts and deductions were paid by you. ~ You IIUSt complete PART ~ and/or PART ~ below. PART If you indicate a different tCf rateL~lease state your ~ relationship to decedent: _ Ut...~_ ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS lINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 I TOTAL (Enter on line 5 of Tax Computation) perjury, I declare that the facts I my k owledge and belief. HOME PART @] DATE PAID PAYEE 50 QCf\:3> \ '1D.1I (Q 1 'X-4~5. OS ~4 'if::) .OS 4. 5010 3~1 ~~ DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID I $ ( n../l/-6r ~ GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on inforllation subllitted by the financial institution. 2. Inheritance tax becolles delinquent nine lIonths after the decedent's date of death. 3. A joint account is taxable even though the decedent's nalle was added as a matter of convenience. 4. Accounts [including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife lIore than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the inforllation and cOllputation in the notice are correct and deductions are not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and subllit thell with your check for the allount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official asses silent [Forll REV-1548 EX) upon receipt of the return froll the Register of Wills. 2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the PennsYlvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 2B060l, Harrisburg, PA 17128-0601 in the envelope provided. 3. BLOCK C - If the notice information is incorrect and/or deductions are being clailled, check block "C" and complete Parts 2 and 3 according to the instructions below. Sign two copies and subllit thell with your check for the allount of tax payable to the Register of Wills of the county indicated. The PA Departllent of Revenue will issue an official assessment [Form REV-1548 EX) upon receipt of the return froll the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one [1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk [MM) appears before your first nalle in the address portion of this notice, the $3,000 exclusion already has been deducted froll the account balance as reported by the financial institution. 2. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is deterllined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Exallple: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 [JDINT OWNERS) DIVIDED BY 2 [SURVIVORS) = .167 X 100 16.7% [TAXABLE FDR EACH SURVIVOR) B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual[s) [trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the nalle of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY 2 [SURVIVDRS) = .50 X 100 50% [TAXABLE FOR EACH SURVIVDR) 4. The allount subject to tax [line 4) is determined by lIultiplying the account balance [line 2) by the percent taxable [line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The allount taxable [line 6) is deterllined by subtracting the debts and deductions [line 5) froll the allount subject to tax [line 4). 7. Enter the appropriate tax rate [line 7) as deterllined below. Date of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% 15% 15% 07/01/00 to present 0% 4.5%. 12% 15% MThe tax rate Il1posed on the net value of transfers froll a deceased ChIld twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in cOllmon with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to adllinistration by a personal representative is insufficient to pay the deductible itells. B. You actually paid the debts after death of the decedent and can furnish proof of paYllent. C. Debts being clailled IIUSt be itellized fully in Part 3. If additional space is needed, use plain paper 8 1/2" x II". Proof of payment may be requested by the PA Departllent of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 * INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 05 - 05Lf;}... 05126372 06-09-2005 REV-15~5 EX iFP 109-001 EST. OF JOSEp:H-!'i1 VERBOS S.S. NO. 179-30-3694 DATE OF DEATH 03-09-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS IX] CHECKING o TRUST o CERTIF. ELLEN M VERB OS 216 CLARK ST LEMOYNE PA 17043 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the inforllation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction froll the finencial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0571108008 Date 05-19-1998 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 4,023.16 16.667 670.54 .00 .00 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax paYllents are made within three (3) months of the decedent.s date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. ~he above information and tax due is correct. ~ 1. You lIay choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. [J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [J The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART @] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) perjury, I declare that the facts I wledge and belief. I $ V' HOME ( WORK ( TELEPHONE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based Dn infDrmatiDn submitted by the financial institutiDn. Z. Inheritance tax becDmes delinquent nine mDnths after the decedent's date Df death. 3. A jDint accDunt is taxable even thDugh the decedent's name was added as a matter Df cDnvenience. 4. AccDunts (including thDse held between husbend and wife) which the decedent put in jDint names within Dne year priDr tD death are fully taxable as transfers. 5. AccDunts established jDintly between husband and wife mDre than Dne year priDr tD death are nDt taxable. 6. AccDunts held by a decedent "in trust fDr" anDther Dr Dthers are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the infDrmatiDn and cDmputatiDn in the nDtice are cDrrect and deductiDns are nDt being claimed, place an "X" in blDck "A" Df Part 1 Df the "Taxpayer RespDnse" sectiDn. Sign tWD cDpies and submit them with YDur check fDr the amDunt Df tax tD the Register Df Wills Df the cDunty indicated. The PA Department Df Revenue will issue an Dfficial assessment (FDrm REV-1548 EX) upDn receipt Df the return frDm the Register Df Wills. Z. BLOCK B - If the asset specified Dn this nDtice has been Dr will be repDrted and tex paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in blDCk "B" Df Part 1 Df the "Taxpayer RespDnse" sectiDn. Sign Dne CDPy and return tD the PA Department Df Revenue, Bureau Df Individual Taxes, oept Z8060l, Harrisburg, PA l7lZ8-060l in the envelDpe prDvided. 3. BLOCK C - If the nDtice infDrmatiDn is incDrrect and/Dr deductiDns are being claimed, check blDck "C" and cDmplete Parts Z and 3 accDrding tD the instructiDns belDw. Sign tWD cDpies and submit them with YDur check fDr the amDunt Df tax payable tD the Register Df Wills Df the cDunty indicated. The PA Department Df Revenue will issue an Dfficial assessment (FDrm REV-1548 EX) upDn receipt Df the return frDm the Register Df Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the accDunt Driginally was established Dr titled in the manner existing at date Df death. FDr a decedent dying after lZ/lZ/8Z: AccDunts which the decedent put in jDint names within Dne (1) year Df death are taxable fully as transfers. HDwever, there is an exclusiDn nDt tD exceed $3,000 per transferee regardless Df the value Df the accDunt Dr the number Df accDunts held. If a dDuble asterisk (MM) appears befDre YDur first name in the address pDrtiDn Df this nDtice, the $3,000 exclusiDn already has been deducted frDm the accDunt balance as repDrted by the financial institutiDn. Z. Enter the tDtal balance Df the aCCDunt including interest accrued tD the date Df death. 3. The percent Df the accDunt that is taxable fDr each survivDr is determined as fDllDWS: A. The percent taxable fDr jDint assets established mDre than Dne year priDr tD the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A jDint asset registered in the name Df the decedent and tWD Dther perSDns. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 l6.7X (TAXABLE FOR EACH SURVIVOR) B. The percent taxable fDr assets created within Dne year Df the decedent's death Dr accDunts Dwned by the decedent but held in trust fDr anDther individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS DR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: JDint aCCDunt registered in the name Df the decedent and tWD Dther persDns and established within Dne year Df death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 50X (TAXABLE FOR EACH SURVIVOR) 4. The amDunt SUbject tD tax (line 4) is determined by multiplying the accDunt balance (line Z) by the percent taxable (line 3). 5. Enter the tDtal Df the debts and deductiDns listed in Part 3. 6. The amDunt taxable (line 6) is determined by subtracting the debts and deductiDns (line 5) frDm the amDunt subject tD tax (line 4). 7. Enter the apprDpriate tax rate (line 7) as determined belDw. Date of Death Spouse Lineal Sibling Collateral 07/01/94 to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% 15% 15% 07/01/00 to present 0% 4.5%11 12% 15% - MThe tax rate lmpDsed Dn the net value Df transfers frDm a deceased Chlld twenty Dne years Df age Dr YDunger at death tD Dr fDr the use Df a natural parent, an adDptive parent, Dr a stepparent Df the child is ox. The lineal class Df heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether Dr nDt they have been adDpted by Dthers, adDpted children and step children. "Lineal descendents" includes all children Df the natural parents and their descendents, whether Dr nDt they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals WhD have at least one parent in common with the decedent, whether by blood Dr adDption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x II". PrDof of payment may be requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. l80601 HARRISBURG, PA 171l8-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 Olj- 054.;)- 05126374 06-09-2005 REV-1545 EX AFP lD9-00l EST. OF JOSEPH M VERBOS S.S. NO. 179-30-3694 DAT~cO~DEATH 03-09-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS IX] CHECKING o TRUST o CERTIF. ELLEN M VERB OS 216 CLARK ST LEMOYNE PA 17043 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth uf Pennsylvania. Quasti"n$ may b.. answen.d by eo..llinr; (717) 787-83l7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0571106935 Date 05-19-1998 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 50,909.31 16.667 8,485.05 .00 .00 TAXPAYER RESPONSE To insure proper credit to your account, two (l) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] The above in~ormation and tax due is correct. 1. You may choose to romit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interes~, or you may check box "An and return this notice to the Register of Wills and an official assessment will bo issued by the PA Department of Revenue. [CHECK] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid wi~h ~ho Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART [!J TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL CEnter on Line 5 of Tax Computation) V' perjury, I declare that the facts I have reported above are true, correct and my knowledge and belief. HOME WORK TEL ~6 GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the finencial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others are taxable fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X" in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one COpy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z8060l, HarriSburg, PA l7lZ8-060l in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being claimed, check block "C" and complete Parts Z and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after lZ/lZ/8Z: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (--) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: 1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 16.7% (TAXABLE FOR EACH ~VrVORJ B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 50% (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. -The tax rate Imposed on the net value of transfers from a deceased ChIld twenty one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Date of Death Spouse Lineal Sibling Collateral 07101/94 to 12/31/94 3X 6X l5X l5X 01/01195 to 06/30/00 OX 6X l5X l5X 07101/00 to present OX 4.5XlI! l2X l5X - CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions-are determined as follows: A. You legally are responsible for payment, or the estate SUbject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CO 005442 ECKERT KAREN 216 CLARK ST LEMOYNE, PA 17043 I ACN ASSESSMENT AMOUNT CONTROL NUMBER _n_____ fold ---------- -------- 05126373 I $30.16 ESTATE INFORMATION: SSN: 179-30-3694 05126375 I $381.83 FILE NUMBER: 2105-0542 I DECEDENT NAME: VERBOS JOSEPH M I DATE OF PAYMENT: 06/16/2005 I POSTMARK DATE: 06/15/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 03/09/2005 I I TOTAL AMOUNT PAID: $411.99 REMARKS: CHECK# 6845 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS