HomeMy WebLinkAbout09-28-09 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
MICHAEL W BURKETT
3 SHADY LANE
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~~'~~',~'%~;~-,-N(3,TLC6-OF'~INHERITANCE TAX
~~ ~`APPRA'ISEMENT,~pLk'DWANCE OR DISALLOWANCE
•-_~~.dF! DEDU:CTZ'ONS~ AND ASSESSMENT OF TAX
2~~~ S~~ Cg ! ~ ~~ ~~ ESTATE OF BURKETT009 MIRIAM E
DATE OF DEATH 02-01-2009
~! :Y.F:', ~~'~~ _ FILE NUMBER 21 09-0361
~R~~'~` ~ '~`~~~-~~+~ COUNTY CUMBERLAND
- _ ~ ,-s, ACN 101
APPEAL DATE: 11-20-2009
PA 17050 (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 ~-- _ _____
-------------------- ----------------------- _____
REV-1547 EX AFP CO1-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BURKETT MIRIAM E FILE N0. 21 09-0361 ACN 101 Herr no_7I_~nno
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
GRrNI iVn wnVtrcnlnV tU I URE INTEREST - SEF REV F'R SG
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) .00 NOTE: To insure proper
(2) .00 credit to your account,
(3) .00 submit the upper portion
of this form with your
(4) .00 tax payment.
(5) 117.343.77
c6) .00
(7) .00
(B) 117, 343.77
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4 95.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10)_ 585 .
11. Total Deductions
C11) 1 .080.3?
12. Net Value of Tax Return 116
263
45
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C12)
(13) ,
.
.00
14. Net Value of Estate Subject to Tax (14J 116,263.45
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) .00 00 00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 116,263.45 _
X
X 045 _ .
5,231.86
17. Amount of Line 14 at Sibling rate (17) .00 X 12 _ .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 _ .00
19. Principal Tax Due
TAX CREDiTS• (19)= 5,231.86
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
04-23-2009 CD011150 261.59 4,970.29
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 5,231.88
BALANCE OF TAX DUE .02CR
INTEREST AND PEN. .00
TOTAL DUE .02CR
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUF~i~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)