HomeMy WebLinkAbout12-17-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BuREau OF' INDIVIDUAL TAxES - - INHERITANCE TAX
INHERITANCE. TAX DIVISION
PD Box zaB6B1 ~ °WRECORD ADJUSTMENT
HARRISBURG PA 17128-0601
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WILLIAM R KAUFMAN E~Q1, ° - ' -' ~ A
SATE B
5140 CENTURY DR
hIECHANICSBURG PA 17055
cl) .00
c2) 5, 615.40
c3) .00
c4) .00
c5) 9,965.41
c6) .00
cn 288,636.36
ca)
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE:: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALOING THIS LINE ~) RETAIN LOWER PORTION FOR YOUR RECORDS •~
REV-1593 EX AFP C03-05) *~ INHERITANCE TAX RECORD ADJUSTMENT *~
ESTATE OF SIMMERS ROBERT L FILE N0. 21 08-0006 ACN 101 DATE 12-04-2008
ADJUSTMENT BASED oN: ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
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. Crash/Bank Deposits/Misc. Personal Property (Schedule E)
6. ,lointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H)
10. Ilebts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Estate Subject to Tax
REV-1593 EX AFP (03-05)
304,217.17
c9) 9, 016.65
clo) .00
cll) 9, 016.65
clz) 295,200.52
Non-elected 9113 Trusts (Schedule J) C13) .00
c14) 295,200.52
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
19. Principal Tax Due
TAY PD (TIT TC.
DATE 12-04-2008
ESTATE OF SIMMERS ROBERT L
DATE OF DEATH 12-22-2007
FILE NUMBER 21 08-0006
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
cis) 295,200.52x 00 = .00
ci6) . 00 x 045= . 00
ci7) . 00 x 12 = . 00
cis) . 00 x 15 = . 00
c19) .00
DATE: NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PA:[D AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIDNAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTroNS-~ ~
}.. INHERITANCE TAX
EXPLANATION
~~~~~,~~:-uxi~.t ~,, Tea ~ F ; ~~ri~~; ~ ;;.ri~~.
o~r~«7r.~f_~ir r~F ~rn~~ OF CHANGES
BUREAU O+= INUiVtt!+)nl (A!Fs
I p.
ti -.
UEGE[)ENT'S NP' 'E F IL!- PJi iLIL~ER
Robert L Simmers 2108-0006
REVIEWED Bl' ACN
Scott Ellison 101
--- ITEM ----- ----- - ------
SCHEDULE NO. EXPLANATION OF CHANGES
Schedule G item # 3 has been removed from the probate return and will be billed directly
to the beneficiary.
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