HomeMy WebLinkAbout09-28-09 (2)COMMONWEALTH OF PENNSYLVANIA
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-NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ARPRAISEMEN~T: ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION _.
PO BOX 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX
HARRISBURG PA 17128-0601
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EARL RICHARD ETZWEILER
ETZWEILER K ASSOCS
105 N FRONT ST
HBG PA 17101
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 BORDNER MATILDA M FILE N0. 21 09-0111 ACN 101 DATE 09-21-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
rtcacicrw~lun ~un~tKn1NG 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) .0 0 NOTE: To insure proper
(2)_ 211.984.11 credit to your account,
C3) .00 submit the upper portion
of this form with your
(4) .00 tax payment.
c5) _ 8 , 812.92
c6) .00
cn .00
Ig) 220,797.03
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) fig) 27,4 71.11
L0. Debts/Mortgage Liabilities/Liens (Schedule I) C10) _ 164 .34
11. Total Deductions
(11) 77.6 ri.4r,
12. Net Value of Tax Return (12) 193, 161 .58
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax I14) 193, 161 .58
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 C15) .00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 04 5 = .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) 193,161.58 X 15 _ 28,974.24
19. Principal Tax Due C19)= 28,974.24
TAX CRFIITTC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
04-22-2009 CD011147 1,448.71 27,525.53
TOTAL TAX CREDIT 28,974.24
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 Sl, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1547 EX AFP CO1-09)
DATE 09-21-2009
ESTATE OF BORDNER MATILDA M
DATE OF DEATH 01-25-2009
FILE NUMBER 21 09-0111
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-20-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0: