HomeMy WebLinkAbout11-09-09BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
WILLIAM C DISSINGER
DISSINGER ~ DISSINGER
400 S STATE RD
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~, i' f` ~`~'~'1'~: ~fil.~i^~ ~'~NHERITANCE TAX
ItP~Itlk2`SEM~1~1~, A~L~bWANCE OR DISALLOWANCE
~ ~~ 8~F , #~E~U,C'~•IffA1S AID ASSESSMENT OF TAX
v REV-1547 EX AFP (01-09)
LQ~~~[~~ _C~ ~~ ~; 4~DATE 11-02-2009
ESTATE OF ADAMS DOROTHY J
~~~~~ i,f; DATE OF DEATH 08-09-2008
~~~~~~,~ ~~~~. FILE NUMBER 21 08-1151
~~~ti~T~''~_~~~`~~~'~ w~~., Pl~ ACNNTY lO1BERLAND
MARYSVILLE PA 17053
APPEAL DATE: 01-01-2010
(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 ADAMS DOROTHY J FILE N0. 21 08-1151 ACN 101 DATE 11-02-2009
TAX RETURN WAS: C 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 tSchedule F)
7. Transfers (Schedule G)
8. Total Assets
C1) .0 0 NOTE: To insure proper
C2) 3,838.12 credit to your account,
submit the upper portion
C3) .0 0 of this form with your
(4) .0 0 tax payment.
C5) 27 , 316.31
c6) .00
C7) .00
C8) 31,154.43
APPROVED DEDUCTIONS AND EXEMPTIONS: 4,539.52
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 1,38 9 .11
11 . Total Deductions C11) ~ • 928 - 63
25,225.80
12. Net Value of Tax Return C12) .0 0
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13)
25, 225.80
14. Net Value of Estate Subject to Tax f14)
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:
00
00
. 00
15. Amount of Line 14 at Spousal rate C15) • =
X
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 25, 225.80 X 045 . 1, 135.16
17. Amount of Line 14 at Sibling rate (17) .00 X 12 .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 1 5 = .0 0
19. Principal Tax Due C19)= 1,135.16
TA]C GK 111:
PAYMEN
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
06-04-2009 CD011318 .00 1,135.16
10-26-2009 SBADJUST .00 4.04
TOTAL TAX CREDIT 1,135.16
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 S1, 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.)