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Home My WebLink About05-0616 CD""ONWEAL TH OF PENNSVL VANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171Z8-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 -OS-bib 05131350 07-05-2005 REV-l!;UElCAfP (09-0(1) EST. OF RALPH E GRIMES 5.5. NO. 182-22-9313 DATE OF DEATH 04-03-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS !Xl CHECKING o TRUST o CERTIF. PA 17013 REHIT PAYHENT AND FDRHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 DIXIE 3 WILBERT CARLISLE L GRIMES DR PNC BANK has provided the Departm'lInt 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 of Pennsylvania. Questions ~ay ha answered by calling (717) 787-83?'7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5140433927 Date 03-26-1990 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 8,380.16 16.667 1,396.72 .00 . DO TAXPAYER RESPONSE To insure proper credit to your account, two Cll copies of this notice must accompany your payment to the Register of Wills. "ake check payable to: "RegistClr of Wills, Agent'". Tax x NOTE: If tax payments are made within three (3l months of thCl decedent's date of death, you may deduct a 5% discount of the tax dUe. Any inheritance tax due will becolle delInquent nine (9) months after the datCl of death. PART [!] The above information and tax due is correct. 1. You may choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "Ao, and retum this notice to the RClgister of Wills and an official assessment will be issued by the PA Dapartment of Revenue. [CHECK ] ONE BLOCK ONLY 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 inforllation is incorrect and/or debts and deductions were paid by you. You lIust complete PART ~ and/or PART ~ below. PART If you indicate a different t~~ate~ please state your @] relationship to decedant: ~ Il tA- c: <:' TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LZNE 1. Dat. Estahli~h.d 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Anount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax ConputationJ I $ Under penalties of perjury, I declare that the (r~let:; the A::::Wledse and belief. TA~ER SIGJ~URE facts I have reported above are truB~ correct and HOME ( WORK ( TELEPHONE ) ) NUMBER 7-?-os DATE Sf<. GENERAL INFORMATION 1. FAILURE TO RESPONO WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based an 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 Nas added as a matter of convenisnce. ~. Accounts (including thosa 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 iointlY between husband and wife morB than one year prior to death are not taxable. 6. Accounts held by a decedent din trust for" another or othars are taxable fully. REPORTING INSTRUCTIONS PART 1 TAXPAYER RESPONSE 1. BLOCK A _ If ths information and COllputatlon in the notice are correct and deductions are not being clailled, 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 allount of tax to the Rsgister of Wills of the county indicated. Thill PA Department of Revenue will issue an official assesSllent (Form REV-15~8 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 Z and 3 according to the instructions below. Sign two copies and submit thelll with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Departllent of Revenue will issue an official assessllent (Form REV-1548 EX) upon receipt of the return from the Register of Wills. TAX RETURN PART 2 - TAX COMPUTATION LINE I. Enter NOTE; the date the account originallY was established or titled in the manner existing at date of death. For a decedent dying after 12/12/62: 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 transferes 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 dsducted 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 parcent of the account that is taxable for each survivor is detsrmined 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 JOINT OWNERS Example: A joint asset registered DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE SURVIVING JOINT OWNERS in the nalle of the decedent and two other pArsons. B. The percent taxable for assets created within one YB8r of the decedent's death or accounts owned by the decedent but held in trust for another individuaHs) (trust beneficiaries): 1 DIVIDED BV 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) "" .167 )( 100 16.7'1. (TAXABLE fOR EACH SURVIVOR) 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEfICIARIES X 100 PERCENT TAXABLE I DIVIDED Joint account registered the decedent. BY 2 (SURVIVORS) = .50 in the name of the decedent and two other persons and established within one year of death by Example; X 100 50~ (TAXABLE FOR EACH SURVIVOR) 4. Ths amount subject to tax lline ~) is determined by multiplying 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 determined by subtracting the debts and deductions (line 5) from the allount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. _The tax rate tMposed on the net value of transfers from a deceased chtld 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 0'1.. 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 definsd as individuals who havs at least one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Data of Daath Spouse Llnaa1 Sibling Collatara1 07101/'4 to 12/31/'4 37. 67. 157. 157. 01/01/'5 to 06/30/00 07. 67. 157. 157. 07101100 to present 07. 4.57." 127. 157. CLAIMED DEDUCTIONS PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, Dr thR sstate subject to administration by a personal representativs 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 itellized fully in Part 3. If additional space is needed, use plain paper 6 1/2" x n". Proof of payment gay be requested by tho PA Department of Revenue. _'" ",,~~" .,""~ '....0.. . ,....I,~.. ...,~.~.~ "............. .. .~~~~~.,_.,-"... ,. .. _.~.. ....-.-... f..:. ..,\ "'1 I,.. r..:. (1,1 ". (Ij (1,1 U:! ,.,) ~ n (\\ (\ f= ~ --- oj ~ '" ~ ~ ~\ -[to ~ ~" ;;- ~ '"'- "?:. r\ u....... '- ~ ~Q ~ , ....... (':} ~ () F ~ ::t. -.J' ~ "- - , - VJ -, - vJ - - - C> ~ ~ r\ so n ~ elw' ==' d '" ::;:_. ~_.X. ~a:f:D >-ar< .....dO -1.... ::1- O' :3 ..... (l) w '" I o an , 6' l) / f I \v ) .....,. i ~ .1