HomeMy WebLinkAbout06-19-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r [ ~ +~ t NdTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~" A~'pRAISF„J1ENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~
PO BOX 280601 ~ iii ~ r w OF 'DEDUCTIONS AND ASSESSMENT OF TAX
HARRISBURG PA 17128-0601
~(~~~ ~~~ ( ~ ~ ~: ~ ~ DATE 06-15-2009
ESTATE OF BISTLINE DOROTHY J
(,~~~~ ~r DATE OF DEATH 08-16-2008
OPPt-!,~.~,~ vv~R-~' FILE NUMBER 21 08-0944
p a ~ ,iCt ;^•~~ ~~ COUNTY CUMBERLAND
STEPHEN L BLOOM GUv~ . -`~ ~- ACN 101
60 W POMFRET ST APPEAL DATE: 08-14-2009
CARL I SL E PA 17013 (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 ALONG THIS LINE ---- ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E~ _ _______
REV-1547 EX AFP CO1-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BISTLINE DOROTHY J FILE N0. 21 08-0944 ACN 101 nsrF n~-I~-~nnq
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
RGJGR~XIlUn ~~n~tKnln~ ruiuRE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To insure
2.
Stocks and Bonds (Schedule B)
(2)
.00 proper
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D)
(4)
00 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 18,19 3.94
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (g) 18, 193.94
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4,374.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions
C11) 4.374.00
12. Net Value of Tax Return (12) 13,819.94
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Sche dule J) C13) .00
14. Net Value of Estate Subject to Tax
(14) 13,819.94
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 13,819
94 00
(15) . X _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .00 X 04 5 = .00
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 00
TAX CRFTITTS• C19)= .
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT .00
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" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)