HomeMy WebLinkAbout03-06-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'NGfleE OF NONRESIDENT INHERITANCE
tAX. APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS,
AND ASSESSMENT OF TAX
AM 8: 41 DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-05-2007
HAGN
08-07-2004
99 05-0323
NON-RESIDENT
101
APPEAL DATE: 05-04-2007
( See reverse side under Objections)
A.ount Remitted I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
PA DEPARTMENT OF REVENUE
P.O. BOX 280601
HARRISBURG, PA 17128-0601
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
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REV-537 EX AFP (03-05) NOTICE OF NONRESIDENT INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
GEORGE H FILE NO. 99 05-0323 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
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JAMES MCCONVltt~ ESQ
7010 LITTLE RV TPKE 320
ANNANDALE VA 22003
ESTATE OF
HAGN
DATE 03- 05-2007
'*'
REV-537 EX AFP (06-05)
GEORGE
H
TAX COMPUTATION METHOD ELECTED: (X) FLAT RATE () PROPORTIONATE
TAX RETURN WAS: (X) ACCEPTED AS FILED ) 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.
Stocks and Bonds (Schedule B)
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
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests (Schedule J)
14. Net Value of Estate Subject to Tax
(1)
(2)
(3)
(4)
(5)
(6)
(7)
320,000.00
.00
.00
.00
.00
.00
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
(8)
320,000.00
(9)
(10)
.00
.00
(11)
(12)
(13)
(14)
.00
320,000.00
.00
320,000.00
NOTE: If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of Abh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line
16. Amount of Line
17. Amount of Line
18. Amount of Line
19. Principal Tax Due
14 at Spousal rate (15) .00 X 00
14 taxable at Lineal/Class A rate (16) 320,000.00 X 045
14 at Sibling rate (17) .00 X 12
14 taxable at Collateral/Class B rate (18) .00 X 15
TAY CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-06-2005 NRoo71oo .00 14,400.00
TOTAL TAX CREDIT 14,400.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
(19)
.00
14,400.00
.00
.00
14,400.00
*
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
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
~
/,,1737-2 ~ + \::l"W*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
NONRESIDENT DECEDENT
ESTATE OF
SCHEDULE A, PART 1
REAL ESTATE
IN PENNSYLVANIA
FILE NUMBER
Part 1 must include all real property owned by the decedent individually or as a tenant in common with another party(ies), having its
situs in Pennsylvania. Property which is jointly-owned with right of survivorship should be disclosed on Schedule F. All real estate
must be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and
a willing seller, neither being compe)J~d to buy or sell, both having reasonable knowledge of the relevant facts.
ITEM i.~.
NUMBER DESCRIPTION VALUE AT DATE OF DEATH
1. r.... S S ~~~'^) G ().. 'f J...,~ S- .., ~d..() GU0
('1 aU
I
CV\{-\ \~\'- 9~
~ ~~\~V\~"'~ ~o-JY -ry
\
\
I
,.
0
PART 1 TOTAL
.. $
. .
PART 2 TOTAL
Proportionate Method Only from reverse side $
TOTAL (Also enter on line 1, Recapitulation) $ 'ld-.O Cf UU
. . I
(If more space IS needed, IOsert addItional sheets of the same size)
JAMES MCCONVILLE ESQ
7010 LITTLE RIVER TURNPIKE # 320
ANNADALE VA 22003
,OMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
RECEIVED FROM:
ESTATE INFORMATION
FILE NUMBER
99 05-0323
NAME OF DECEDENT (LAST)
HAGN
DATE OF PAYMENT
POSTMARK DATE
COUNTY
Non-Resident
DATE OF DEATH
REMARKS
VA
SEAL
p.NHSYLVANIA
INHERIT..,.CE AND EsTATE TAX
~O~f'~'* I'IIECEIPT
l.u\il hp,PNo. NR007100
ACN
ASSESSMENT
CONTROL
NUMBER
101
(FIRST)
GEORGE
(MI)
H
5/11/2005
5/6/2005
8/7/2004
AMOUNT
14,400.00
TOTAL AMOUNT PAID
$14.400.00
RECEIVED BY
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
Register
John M. Riedman
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