HomeMy WebLinkAbout10-17-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, 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)
._ ,'t; ~, ~ ,~ i'~ i~~' ~,-~ DATE 10-13-2008
ESTATE OF JURGENSEN CHARLES A
~~ DATE OF DEATH 03-05-2008
ref ~•~ ~=~~ FILE NUMBER 21 08-0272
~,`~? - (%`-. COUNTY CUMBERLAND
JIAMES D FLOWER JR' ESQ ACN 101
S~AIDIS ETAL APPEAL DATE: 12-12-2008
2'6 W H I GH ST (See reverse side under Objections)
CARLISLE PA 17013 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --1 RETAIN LOWER PORTION FOR YOUR RECORDS E-
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REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JURGENSEN CHARLES A FILE N0. 21 08-0272 ACN 101 DATE 10-13-2008
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds [Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property [Schedule F)
7. Transfers [Schedule G)
8. Total Assets
C1)
.00
C2) 88,274.00
C3) .00
c4) .00
c5) 185,490.06
C6) .00
17) .00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
fig) 273, 764.06
APPROVED DEDUCTIONS AND EXEMPTIONS: 17,895.99
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
L0. Debts/Mortgage Liabilities/Liens [Schedule I) (10) 1,241.31
11. Total Deductions (11)
19.137.30
12. Net Value of Tax Return C12) 254,626.76
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) 14,000.00
14 Net Value of Estate Subject to Tax C14) 240,626.76
.
NOTE: If an assessment was issued previously, l ines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed 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) 240,626.76 X 045 = 10,828.20
17. Amount of Line 14 at Sibling rate (17) •00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) •00 X 15 = .00
19 Principal Tax Due (19)= 10,828.20
.
Tw ro rnrrc•.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
06-03-•2008 CD00982
~ 526.32 10,000.00
07-21-•2008 CD010038 .00 301.88
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 10,828.20
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DU
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