HomeMy WebLinkAbout08-15-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES AP;PRAISEMENT,-ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601 REV-1547 EX AFP (06-05)
~"`"~~ ~"''' + ~ r~ ~ ~' t$~ ESTATE OF GOLDSTROMB PETER E
DATE OF DEATH 01-25-2007
`,~ `~ ~ " (' FILE NUMBER 21 07-0130
ORr'f ~`~;~~~ ` ~ '1t,~L7T COUNTY CUMBERLAND
WILLIAM L GRUBB ESQ C~~~ '' ra ACN 101
3803 GETTYSBURG RD ~ ~'~ APPEAL DATE: 10-17-2008
CAMP H I L L PA 17 011 (See reverse side under Objections)
A~ount ReAitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GOLDSTROM PETER E FILE N0. 21 07-0130 ACN 101 DATE 08-18-2008
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 114,000.00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 11,44 2.4 9
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (B) 125,442.49
APPROVED DEDUCTIONS AND EXEMPTIONS:
16,226 .97
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
11. Total Deductions (11) 16.?26.97
12. Net Value of Tax Return (12) 109,215.52
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) •00
14. Net Value of Estate Subject to Tax (14) 109,215.52
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 ALL returns assess ed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) •00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 109,215.52 X 045 = 4,914.70
17. Amount of Line 14 at Sibling rate (17) .00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 _ .00
19. Principal Tax Due (19)= 4,914.70
TAY f DCTTTC.
PAYMENT
DATE RECEIPT
NUMBER D SCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
01-14-2008 (0009167 85.32- 5,100.00
08-11-2008 REFUND .00 99.98-
IUTAL IA)C CREDIT 4,914.70
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. ~
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)