HomeMy WebLinkAbout02-27-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
t~ ,NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES r,~.;,,~• et _'i'!. ~4,Abt~R`1A~'S~MENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION - ,OF'D~DUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 _ '_ ~',~ ~,
HARRISBURG PA 17128-0601 ~ ;`~ ~ k ,.i ~i V
2Q49 F EB Z~ A~ t t~ t a
r, ~~
CL~i~,~C ~..
-„-~~~~~~5 r`~tJR
MARLIN MCCALEB ~~ryf , ~ ~*+i ~ +"',~ ~~
219 E MAIN ST CL~ '`; l
PO BOX 230
MECHANICSBURG PA 17055
REV-1547 EX AFP CO1-09)
DATE 02-24-2009
ESTATE OF CZAJKOWSKI FRANCIS E
DATE OF DEATH 01-28-2008
FILE NUMBER 21 08-0595
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-25-2009
(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 ALON_6 THIS LINE _ ~ R_ETA_IN LOWER PORTION FOR YOUR RECORDS ~ _ ---------------
REV-1547 EX AFP (01-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE DF CZAJKOWSKI FRANCIS E FILE N0. 21 08-0595 ACN 101 DATE 02-24-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANCED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 4 6,900.00 NOTE: To insure proper
2 Stocks and Bonds (Schedule B) (2) ,OQ credit to your account,
. 00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) . 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) 84,272.44
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
(g) 131,172.44
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: 23,915.88
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)' C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 764.6 7
11. Total Deductions (11) 24.680 . ~~
106,491.89
12. Net Value of Tax Return (12)
.0 0
13. Charitable/Governmental Bequests; Non-elected 9113 Tru sts (Sch edule J) C13)
106,491.89
14. Net Value of Estate Subject to Tax C14)
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 (15) •00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 106,491 .89 X 045 = 4,792.14
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00
19. Principal Tax Due
r w rnrnrrc. (ly)= 4,792.14
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
10-24-2008 (0010451 .00 4,792.14
^ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 4,792.14
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
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)