HomeMy WebLinkAbout08-03-09BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
-.DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
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ELYSE E ROGERS
KEEPER ETAL
635 N 12TH ST STE 400
LEMOYNE PA 1.7043
REV-1547 EX AFP (01-09)
DATE 07-27-2009
ESTATE OF HAWLEY ROY F
DATE OF DEATH 11-25-2008
FILE NUMBER 21 08-1208
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-25-2009
(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 ---- --~ 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 HAWLEY ROY F FILE N0. 21 08-1208 ACN 101 DATE 07-27-2009
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
KtJtKVAIlUN 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) 861.942.09 credit to your account,
C3) .00 submit the upper portion
of this form with your
C4) .00 tax payment.
c5) 14,287.87
I6) .00
cn .00
ca) 876,229.96
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) •00
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13
(10)_ 0
C11) _ 00
c12) 876,229.96
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 876,229.96
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 (15) 876,229.96 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) . 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 C18) .00 X 15 _ .00
19. Principal Tax Due 00
TAY rQCnrTe. (lg)= .
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
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 $1, NO PAYMENT IS REpUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE /~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) !~-y~l/