HomeMy WebLinkAbout07-06-09 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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BUREAU OF INDIVIDUAL TAXES ~
,, AP,P~tf4'~~EMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION
PD BOX 280601
..: OF p'EDU'CTIONS AND ASSESSMENT OF TAX "
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HARRISBURG PA 17128-0601 .t ~, ~ ~ "
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REV-1547 EX AFP CO1-09)
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ESTATE OF ROLLER DOROTHY L
DATE OF DEATH 01-05-2008
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FILE NUMBER 21 OS-1212
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COUNTY CUMBERLAND
JERRY R DUFFIE (y
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301 MARKET ST APPEAL DATE: 08-28-2009
PO BOX 109 (See reverse side under Objections)
LEMOYNE PA 17043-0109 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-
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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 ROLLER DOROTHY L FILE N0. 21 08-1212 ACN 101 DATE 06-29-2009
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) (1) .00
2. Stocks and Bonds (Schedule B) (2) 1 , 951 .22
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) C4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 16,777.04
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets Cg)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
18,728.26
APPROVED DEDUCTIONS AND EXEMPTIONS: 4,632.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
I0. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
11. Total Deductions (11) 4.67.00
12. Net Value of Tax Return C12) 14,096.26
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (lG) 14, 096.26
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) 14, 096.26 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 C17) •00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) •0 0 X 15 _ .00
19. Principal Tax Due (19)= .00
TAY f DCTTTC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
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
C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DU
e aFFUNn" SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)