HomeMy WebLinkAbout06-26-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
i
BUREAU OF INDIVIDUAL TAXES ~'. Apl~f~AI,SEMENT,;ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OFD DEDUG'TIONS AND ASSESSMENT OF TAX
PO BOX 280601 REV-1547 EX AFP CO1-09)
HARRISBURG PA 17128-0601 - - ~" ~-
DATE 06-22-2009
l~0~ .~~~ ZC! Pr { ~ { 7 ESTATE OF EVENS CAROLYN J
DATE OF DEATH 11-08-2008
CI..ERt<C1,F FILE NUMBER 21 08-1219
ORPN,aN'S CUUR1 COUNTY CUMBERLAND
THOMAS E FLOWER C~~~'t~f ~A.`~Yti e~., ~~. ACN 101
SAIDIS ETAL APPEAL DATE: 08-21-2009
2109 MARKET ST (See reverse side under Objections)
CAMP HILL PA 17011 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ --1 R_ETA_IN LOWER PORTION FOR YOUR RECORDS 4- _ _______________
REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
r~rwrr nr FVFNS CAROLYN J FILE N0. 21 08-1219 .ACN 101 DATE 06-22-2009
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)
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
C1) .00 NOTE: To insure proper
(2)
(3) 262.436.74
.00 credit to your account,
submit the upper portion
of this form with your
(4) .00 tax payment.
(5) .00
(6) .00
C7) 54,987.90
(B) 317,424.64
APPROVED DEDUCTIONS AND EXEMPTIONS: .00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0
11. Total Deductions (11) .00
317,424.64
12. Net Value of Tax Return (1z) 15, 000.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedu le J) (13) 302,424.64
14. Net Value of Estate Subject to Tax (14)
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: 302,424.64 00 _ .00
15. Amount of Line 14 at Spousal rate (15)
00 X
04 5
.00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) . X . 00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .
00
Amount of
18 Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 .
. .00
19. Principal Tax Due C19).
TA)C GKtLl 15
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
TOTAL TAX CREDIT .uu
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN S1, 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.)