HomeMy WebLinkAbout05-22-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAI'SEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 _ .
HARRISBURG PA 17128-06D1 REV-1547 EX AFP CO1-09)
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JEFFREY S COHICKEA ~;'':
COHICK & ASSOC
390 ALEXANDER SPRNG R
CARLISLE PA 17015
DATE 05-18-2009
ESTATE OF KEIEFAUVER JOHN H
DATE OF DEATH 03-20-2008
FILE NUMBER 21 08-0388
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-17-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF ~~IILLS
CUMBERLAND CAD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ---- -~ RETAIN LOWER PORTION FOR YOUR RECORDS E-
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REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLDWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE DF KEEFAUVER JOHN H FILE N0. 21 08-0388 ACN 101 DATE 05-18-2009
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) (1) 110,.000.00 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) (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) 12:.121.4 2
6. Jointly Owned Property (Schedule F) (6) 23:.452.01
7. Transfers (Schedule G) (7) .00
8. Total Assets (g) 145, 573.43
APPROVED DEDUCTIONS AND EXEMPTIONS:
32,814.61
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 311.4 2
11 . Total Deductions C11) i3 •) 96 - 03
12. Net Value of Tax Return (12) 112,447.40
13. Charitable/Governmental Bequests; Non-elected 9113 Tru sts (Sch edule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 112,447.40
NOTE: If an assessment was issued previously, lines 14, 15 andi'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 C16) 112,447.40 X 045 = 5,060.13
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 (lg)= 5, 060.13
TAY CRFTITTC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
12-22-2008 CD010674 .00 5,060.13
05-11-2009 SBADJUST .00 1.94
TOTAL TAX CREDIT 5,060.13
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .DO ~
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 8'.L, NO PAYMENT IS REpUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED A'i A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)