HomeMy WebLinkAbout07-06-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~NQTfiCf~j~QF,-INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMEN~f-.a~lL~rpWA~NeE;~ 6R DISALLOWANCE
INHERITANCE TAX DIVISION OF D{; C~' fA,ND, ASSESSMENT OF TAX
PO BOX 280601 r~~ t~r~ .4 'I t
HARRISBURG PA 17128-0601 " ` REV-1547 EX AFP CO1-09)
Z~Qg~~~ _~ Qy+~A~~ 06-29-2009
S E OF KEEFAUVER PATRICIA G
DATE OF DEATH 08-17-2008
~C~~(~ FILE NUMBER 21 09-0125
0~}"~~'S ~OUNTY CUMBERLAND
JEFFREY S COHICK ~. ~N 101
390 ALEXANDER SPRING RD ~ APPEAL DATE: 08-28-2009
CA R L I S L E PA 17 015 (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 KEEFAUVER PATRICIA G FILE N0. 21 09-0125 ACN 101 DATE 06-29-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) C2) ,0 0 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) L3) •00 of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .00
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) C7) 183, 111.38
8. Total Assets cB) 183, 111.38
APPROVED DEDUCTIONS AND EXEMPTIONS: .00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions C11) -~~
12. Net Value of Tax Return C12) 183, 111.38
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) •00
14. Net Value of Estate Subject to Tax (14) 183, 111 .38
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 C15) X
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 183, 111.38 X
17. Amount of Line 14 at Sibling rate (17) •00 X
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •~~ X
19. Principal
r w rornrro. Tax Due
00 =
00
045_ 8,240.01
12 _ .00
15 _ .00
cly)= 8,240.01
- PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
02-05-2009 CD010861 .00 8,240.01
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
8,240.01
.00
.00
.00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. ~
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
e RFFIINn_ sFF REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS-)