HomeMy WebLinkAbout01-23-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
~ r, ,- ~ ( ,AIOT.ICk, OF INHERITANCE TAX
I - ,gppj2p,.I+$~~1~E:NT i; ALLOWANCE OR DISALLOWANCE
OF(AEpU'CTI'ONS AND ASSESSMENT OF TAX
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MICHAEL CHEREWKA ~G~, ~ - ._ ,
M CHEREWKA LAW OFCS
624 N FRONT ST
WORMLEYSBURG PA 17043
c15) ' 00 X
t16) 114,910.59 X
c17) ' 00 X
cla) ' 00 X
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
RETAIN LOWER PORTION FOR YOUR
~
THIS LINE RECOR
--------------
__
-____
CUT ALONG
REV-1547 EX AFP (12-08)
ANDRASSES
R
N SMENTAOFOTAXCE OR
DEDUCTIONS
OF
DISALLOWANCE 101 DATE 01-19-2009
LOIS D FILE N0. 21 08-0291
BARR
ACN
ESTATE OF
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
170,000.00
NOTE: To insure proper
C1)
1. Real Estate (Schedule A) 9.4 07.04 credit to your account,
~2)
2. Stocks and Bonds (Schedule B)
'00
submit the upper portion
f this form with your
(3)
Closely Held Stock/Partnership Interest (Schedule C)
3 ,00 o
tax payment.
.
(4)
4. Mortgages/Notes Receivable (Schedule D) 11 +718.53
Cash/Bank Deposits/Misc. Personal Property (Schedule E) C6j
5 2$1.06
.
6. Jointly Owned Property (Schedule F) 30,379.40
~~)
7. Transfers (Schedule G) CB) 221,786.03
g, Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: 30,606.62
ioj
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
9 26$
$2
7 6
(
.
10. Debts/Mortgage Liabilities/Liens (Schedule I) _..
_
,
C11)
~6.g7F.44
11. Total Deductions C12) 114,910.59
12. Net Value of Tax Return
/Governmental Bequests; Non-elected 9113 Trusts (Sc
l
hedule J) (ioj .00
114,910.59
e
13. Charitab
14. Net Value of Estate Subject to Tax
~
a
and 19 will
7
t
assessed
NOTE: If
1~of1ALL returns
t
1
p
t
s
n date,
o
a
to
the
that include
fi9umes
t
I
ref ec
ASSESSMENT OF 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 r_RFnITS: ____ nTCrn11NT (+)
PAYntnl '"'"'-~~ INTEREST/PEN PAID C-)
DATE NUMBER , 00
09-29-2008 CD010331 ,00
01-12-2009 SBADJUST~
REV-1547 EX AFP (12-OB)
00 _ .00
045= 5,170.98
12 .00
15 .00
5, 170 .98
c19)=
AMOUNT PAID
5,170.98
.99
TOTAL TAX CREDIT 5,170.98
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( 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
e rtFFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
DATE 01-19-2009
ESTATE OF BARR LOIS D
DATE OF DEATH 12-28-2007
FILE NUMBER 21 08-0291
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-20-2009
(See reverse. side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0: