HomeMy WebLinkAbout09-08-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
"~•'" ~ '"^~-~'~''iN~T~ICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES J~ :pP~RAT.~EMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION "^
PO BOX 280601 rji~,,~tl~}L~1 ~OF ;I~~pUCTIONS AND ASSESSMENT OF TAX
HARRISBURG PA 17128-0601
rr AA t~11 REV-1547 EX AFP CO1-09)
Z~O~SGP `8 H~ 9' 2u DATE 08-31-2009
ESTATE OF KLOUSER MARLIN H
v ~~~~~~t~~ c~ DATE OF DEATH 08-02-2008
a~'~NAN'S ~~ FILE NUMBER 21 08-0969
HARRY J BROWN ESQCU~ .:~~~~ ~., FAA COUNTY CUMBERLAND
ACN 101
PFEIFFER ETAL APPEAL DATE: 10-30-2009
1800 WEST END AVE (See reverse side under Objections)
POTTSVILLE PA 17901 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 ~ _________
-------------------- --------------------------------------------------
REV-1547 EX AFP CO1-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KLOUSER MARLIN H FILE N0. 21 08-0969 ACN 101 DATE 08-31-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
RtJtKYAI1UN c:uNGERNING 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:
(1) 276, 003.00 NOTE: To insure proper
C2) .00 credit to your account,
C3) .00 submit the upper portion
of this form with your
(4) .00 tax payment.
c5)_ 18.031.30
c6) .00
cn .00
~$) 294, 034.30
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Iy) 15,232.01
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 24.583 .39
11. Total Deductions
(11) X9.81 x.40
12. Net Value of Tax Return X12) 254,218.90
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax X14) 254,218.90
NOTE: If an assessment was issued previously, l ines 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) 254,218.90 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .0 0 X 045 _ .00
17. Amount of Line 14 at Sibling rate X17) .00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 _ .00
19. Principal Tax Due 00
TAY f DrflTTC. C19)= .
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 ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. ~~~
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUFF//~}-~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ V