HomeMy WebLinkAbout07-24-09 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES --•;APPRA'iS~M~NT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 ~_ _
HARRISBURG PA 17128-0601 ,.,
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PO BOX 318
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ -• R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~- _ _______________
REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOLLINGER GWEN D FILE N0. 21 08-0962 ACN 101 DATE 07-20-2009
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
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
cl) .00
c2) .00
c3) .00
c4) .00
c5) 3.953.77
c6) .00
cn .00
ca)
15,804.77
(9)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
3,953.77
cl0) 641.94
(11) 16.446.71
I12) 12,492.94-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
c13) • 00
c14) 12,492.94-
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
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
Tex rornrrc.
DATE 07-20-2009
ESTATE OF HOLLINGER GWEN D
DATE OF DEATH 08-18-2008
FILE NUMBER 21 08-0962
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-18-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
C15)
.00 X
I16) . 00 X
c17) • 00 X
cls)
00 X
00 _ .00
045 _ .00
12 _ .00
15 = .00
c19)= .00
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT .00
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 $1, NO PAYMENT IS REQUIRED. ///~~~
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE III
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ,~~',~VJ/