HomeMy WebLinkAbout81-00069
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
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COUNTY FILE NO:
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ESTATE
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FILE NO,
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COUNTY
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DATE OF DEAT/J
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Appraised Value of Estato:
Real Estate
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Personal Property
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Jointly Hold Properly/Transfers
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$ ! /' 1/ ..
Total Gross Estate
Total Approved Oeductions
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Clear Value of Estate
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Less: Approved Charitable Exemptions
Clear Value of Estate Subject to Tax
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Amount Taxable @ 6% Rate
$
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Amount Taxable @ 15% Rate
tax due
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TOTAL PENNSYLVANIA INHERITANCE TAX'DUE,"-'I1.v;,....:"
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.. * ... * ... * A five percent discount totaling $
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
$
t
$
$
= $
t
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t
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Interest accrues at the rate of six (61 percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by is "--'._._-
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE -/;.:,,,y/I,"'i'/';, "; /~/"././
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Assessed by: / ,(A. I (,
See Information on Rcvcrsc Side Agenl for the Commo," ealth4~_
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COMMONWEAL TH OF PENNSn VANIA
OEPARTMENT OF REVENUE
,TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
IHHERIT ANCE TAX RETURN
FOR INSOLVENT ESTATES
(Instructions on Reverse Side)
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Social Socuri ty No. J.. 00 - .2-1 - /0 ,3/" 2
TYPE OF ASSET
DESCRIPTION
COUNTY NO. .~()
STATE NO.
(v( Exec, () Adm, Other
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Name " ('UA l~ , &l::IA 'l>>V '
Social Security No. () .'3 - (j) 0 ,- C :; ~J')-
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Date
Signature of fIduciary
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TOTAL
ESllMA TEO MA KEf
VALUE
DEPARTMENT VALUATION
(OFFICIAL USE ONLY)
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I do hereby certify that the above assets were appraised in accordance witli Pennsylvania low.
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OFFICIAL
USE
ONLY
DATE
NAME OF PAYEE
OFFICIAL
USE
ONLY
11- 19d.-.;1
$ _ ~:l11,(H
o DUC.TIONS AL.LOWED
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APPRAISER
NATURE OF CLAIM
AMOUNT CLAIMEO
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TOTAL
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, RE TER OF WIL.L.$ ,
C. 91
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DATE