HomeMy WebLinkAbout06-19-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
n .- ~ n '-„ '.~-NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~~~ -~.''~APFRALSEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION - ~ p'F DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 4 _, ~ 1.t'~~ ` '
HARRISBURG PA 17128-0601
2009 JUN 19 PM 2~ 0~
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THOMAS E FLOWER ~ -
SAIDIS ETAL
2109 MARKET ST
CAMP HILL PA 17011
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 CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BURKEY EVELYN G FILE N0. 21 07-0957 ACN 101 DATE 06-15-2009
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 707,973.42 NOTE: To insure proper
(2) 5, 5 00.00 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 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, 074.96
6. Jointly Owned Property (Schedule F) (6) 21, 268.06
7. Transfers (Schedule G) (7) .00
(B) 739,816.44
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
46,563.87
C9)
(lo) 6.052.26
C11) ~+ .616.13
(1z) 687,200.31
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax
(14) 687,200.31
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
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
• 00 00 . 00
c15) X =
c16) 687,200.31 X 045 = 30,924.01
(17) • 00 X 12 . 00
(18) .00 X 15 .00
(19)= 30,924.01
1 RA V R GL 1 1 J
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
08-21-2008 CD010181 .00 30,000.00
01-16-2009 CD010785 210.31- 1,134.32
BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-17-2009 TOTAL TAX CREDIT 30,924.01
BALANCE OF TAX DUE .00
INTEREST AND PEN. 28.88
TOTAL DUE 28.88
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1547 EX AFP CO1-09)
DATE 06-15-2009
ESTATE OF BURKEY EVELYN G
DATE OF DEATH 10-16-2007
FILE NUMBER 21 07-0957
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-14-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0: