HomeMy WebLinkAbout06-26-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
- NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES _ 'gpp~AI$EMENT; ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~: QF,DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 -- -
HARRISBURG PA 17128-0601
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KATHLEEN A PALUBQ""~,
225 NORTH MAIN ST
SHENANDOAH PA 17976
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~'--1 RETAIN LOWER PORTION FOR YOUR RECORDS •-- ______________
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REV-1547 EX AFP (O1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
~creTF aF ROZENBURCH EUGENE FILE N0. 21 08-0559 ACN 101 DATE 06-22-2009
TAX RETURN WAS: C 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)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
~1) .00 NOTE: To insure proper
(2)
C3) .00
.00 credit to your account,
submit the upper portion
of this form with your
~4) .00 tax payment.
c5) 22,773.72
c6) .00
c7) .00
c8) 22,773.72
APPROVED DEDUCTIONS AND EXEMPTIONS: 6,249.75
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 28.594.21
X11) ;4.843.96
11. Total Deductions 12,070.24-
12. Net Value of Tax Return (12) .00
13 Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13)
. 12,070.24-
14. Net Value of Estate Subiect 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:
00
00
.00
15. Amount of Line 14 at Spousal rate C15) . X =
16. Amount of Line 14 taxable at Lineal/Class A rate (16) • 00 X 045 . . 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 (18) •00 X 15 = .00
C19)= .00
19. Principal Tax Due
IAA bRCL11J'
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT .oo
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 REpUIRED.
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 (01-09)
DATE 06-22-2009
ESTATE OF ROZENBURCH EUGENE
DATE OF DEATH 04-16-2008
FILE NUMBER 21 08-0559
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-21-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0: