HomeMy WebLinkAbout04-04-07
~ OF INDIVIDUAL
INHERITANCE TAX OIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
TAXES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP (06-05)
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG PA 17055
DATE 04-02-2007
ESTATE OF SAMPSON RAYMOND J
DATE OF DEATH 04-17-2006
FILE NUMBER 21 06- 0394
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 06-01-2007
( See reverse side under Objections)
Amount Remittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS +-
REY:is47-Ex-AFP-C03:osj-NoTlcE-OF-INHERITANCE-TAX-APPRAIsEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~~ ,
= pc,
RAYMOND J FILE NO. 21 06-0394 ACN 1~() DATE-'04-Q2,-'2007
.-' -..-oJ .,.,.......," ,
S€:e-~T ACijgn NOTI-CE
- ;~,~~ 1- ~_:'
ESTATE OF
SAMPSON
TAX RETURN WAS: (
) ACCEPTED AS FILED
( X) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2.
3.
4.
5.
6.
7.
8.
00 '- l.'>_/ -0
'-)C_:m:rTE: T.ll1':insur-e. !fFpper
208,363.53=-:'jj:red:t .l9. your-pa~~oun~,
00- . _"",ubml t the uPP.lfr:pl.lrtlon
. :;'Z of this~rm with 'your
.00-'" tax payrn!9r,t.
308,193.87
.00
.00
Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Closely Held Stock/Partnership Interest (Schedule C)
Mortgages/Notes Receivable (Schedule D)
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
Jointly Owned Property (Schedule F)
Transfers (Schedule G)
Total Assets
(8)
516,557.40
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
(9)
ClO)
37,650.39
.00
(11 )
Cl2)
Cl3)
Cl4)
37.6IiD.39
478,907.01
.00
478,907.01
Net Value of Tax Return
12.
13.
14.
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject ~o Tax
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
NOTE:
Cl5)
Cl6)
Cl7)
Cl8)
121,560.97 X
357,346.04 X
.00 X
.00 X
00
045 =
12 =
15 =
19. Principal Tax Due _
TAX CREDITS'
Cl9)=
.00
16,080.57
.00
.00
16,080.57
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-07-2006 CD006944 675.00 12,825.00
12-20-2006 CD007587 .00 430.66
INTEREST IS CHARGED THROUGH 04-17 -2007 TOTAL TAX CREDIT 13,930.66
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 2,149.91
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 42.37
TOTAL DUE 2,192.28
\
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE ~