HomeMy WebLinkAbout09-28-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
' ~ _,- -_ - NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ` "',__ ''_APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION pF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 -
HARRISBURG PA 17128-0601 ~ ~ `
21t'9 SAP 2~ rs=i 2~ 4$
H ANTHONY ADAMSuI, i`, ` ?~
STE 3
49 W ORANGE ST
SHIPPENSBURG PA 17257
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ---- ~ RETAIN LOWER PORTION FOR YOUR RECORDS H
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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 KEEPER ARTHUR J FILE N0. 21 08-0268 ACN 101 DATE 09-21-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
M;ESERVATION 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:
(1) 200,000.00 NOTE: To insure proper
C2) 25,625.55 credit to your account,
(3) .00 submit the upper portion
of this form with your
C4) .00 tax payment.
c5) 28 , 878.94
c6) .00
cn .DO
cB) 254,504.49
9. Funeral Expenses/Adm. Costs/Misc. Expenses [Schedule H) ~q) 39,373.62
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions I11) 39.373-6
12. Net Value of Tax Return X12) 215, 130.87
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) 21,513.00
14. Net Value of Estate Subject to Tax C14) 193,617.87
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 X15) .00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 193, 617.87 X 045 = 8, 712.80
17. Amount of Line 14 at Sibling rate (17) .0 0 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) •00 X 15 _ .00
19. Principal Tax Due C19)= 8,712.80
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
11-21-2008 CD010547 .00 9,000.00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
REV-1547 EX AFP (01-09)
DATE 09-21-2009
ESTATE OF KEEPER ARTHUR J
DATE OF DEATH 02-22-2008
FILE NUMBER 21 08-0268
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-20-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
TOTAL TAX CREDIT 9,000.00
BALANCE OF TAX DUE 287.20CR
INTEREST AND PEN. .00
TOTAL DUE 287.20CR
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REpUIRED.
IF TOTAL DUE IS! REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE,j
A REFUND. SEE KEVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) `~~~_//