HomeMy WebLinkAbout11-21-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
- --_NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES AppQgIS[MENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION DF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG IPA 17128-0601 ~ REY-1547 EX AFP (06-05)
*1.aRti ,,„.~~ ~ ~ ~„~~ ~~~ ~~ DATE 11-17-2008
ESTATE OF CLAY BEVERLY A
DATE OF DEATH 05-15-2008
~-~' ~ f-=' _ FILE NUMBER 21 08-0823
Ut~i~`i;~ , ~ ~•r`~~'~~ COUNTY CUMBERLAND
.IEFFREY B CLAY C~ II { 1 ' ~ ~~ ACN 101
233 GETTYSBURG PIKE APPEAL DATE: 01-16-2009
t4ECHANICSBURG PA 17055 (See reverse side under Objections)
Amount Remitted --~
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 E--
REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CLAY BEVERLY A FILE N0. 21 08-0823 ACN 101 DATE 11-17-2008
TAX RETURN WAS: (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) C1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) ,00 credit to your account,
.00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 26,4 32.58
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) C7) .00
8. Total Assets (g) 26,432.58
APPROVED DEDUCTIONS AND EXEMPTIONS: 5,211.00
9.. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 14.152 .82
11. Total Deductions (11) 19.363.82
12. Net Value of Tax Return (12) 7, 068.76
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00
tate Subject to Tax
f E
t V
l
N ClG) 7,068.76
14. ue o
s
e
a
NOTE: If an assessment 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 C15) • 00 X 00 = . 00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 7,068.76 X 045 = 318.09
1T. Amount of Line 14 at Sibling rate C17) .00 X 12 = .00
181. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
151 al Tax Due
Princi (19). 318.09
. p
~~ PAYMENT~v
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-3 AMOUNT PAID
08-08-2008 CD010109 15.9D 302.19
TOTAL TAX CREDIT 318.09
BALANCE OF TAX DUE .00
INTEREST AND PEN. .QO
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE C~
w ocrnun sFF REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) L