HomeMy WebLinkAbout02-20-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
,;-'~C,~""'"tNO. ~_ ~'0~'~' INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES A~Pltl~i3~E?1EIV ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ,~ '~~' .pETiU,GT~ONS' AND ASSESSMENT OF TAX
PO BOX 280601 ~ ~, t,li;J " ~. ~ ~ - _ -
HARRISBURG PA 17128-0601 REV-1547 EX AFP CO1-09)
Z409FEB20 AMI~~23 DATE 02-16-2009
ESTATE OF KOSHEBA REGINA M
CL~~}~h~ DATE OF DEATH 11-07-2007
FILE NUMBER 21 07-1041
~RPNAI~~S ;'~JURT COUNTY CUMBERLAND
J RAYMOND AMBROSE JR E~~L~~"~`'i~._+~'~.~'~~!,~~ ~~~~, P~ ACN 101
AMBROSE LAW CENTRE APPEAL DATE: 04-17-2009
8 01 F R E E P O R T R D (See reverse side under Objections
NEW KENSINGTON PA 15068 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 ~ --------------
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REV-1547 EX AFP (01-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KOSHEBA REGINA M FILE N0. 21 D7-1041 ACN 101 DATE 02-16-2009
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. O1
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) I2) ,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) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 5,411.46
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets Ig) 5,411.46
APPROVED DEDUCTIONS AND EXEMPTIONS:
1,277.29
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
11. Total Deductions C11) ~ •~7~-?9
4
134
17
12. Net Value of Tax Return C12) ,
.
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 209,896.09
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 assessed 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 (16) 209,896.09 X 045 = 9,445.33
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)= 9,445.33
TAY f DC~IT TC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+
INTEREST/PEN PAID (-)
AMOUNT PAID
01-29-2008 CD009242 447.37 8,500.00
04-08-2008 CD009531 .00 311.93
08-19-2008 CD010173 .O1- 186.04
02-09-2009 SBADJUST .00 .42
TOTAL TAX CREDIT 9,445.33
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 S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE D
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)