HomeMy WebLinkAbout11-09-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~ ~ .,~ ~~, 0 .~~.CE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~ ~ '~ ~~~'~APP,,~t'~~Ss~M~J+1`T, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~;, ,D,P+ DEDU~TI~NS AND ASSESSMENT OF TAX
PO BOX 280601 t ,'t~'~,,i ~ # `, ' ~,3ti ; `e t :.;
HARRISBURG PA 17128-0601
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WANDA K DIETRICH ~~,;~~}"`~ ,;~~~;-(~ ~~.' p
ROTZ K STONESIFER
1134 KENNEBEC DR
CHAMBERSBURG PA 17201
REV-1547 EX AFP CO1-09)
DATE 11-02-2009
ESTATE OF COOVER ALICE M
DATE OF DEATH 02-21-2009
FILE NUMBER 21 09-0190
COUNTY CUMBERLAND
ACN 101
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 E~ _
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REV-1547 EX AFP CO1-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COOVER ALICE M FILE N0. 21 09-0190 ACN 101 _______________
--
OR
DATE 11-02-2009
TAX RETURN WAS: (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) (1) .0 0 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) 324, 130.61 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) .0 0
(3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .0 0 tax payment.
5. CashlBank Deposits/Misc. Personal Property (Schedule E) C5) 112 , 361 .09
6. Jointly Owned Property (Schedule F) (6) 24,551.41
7. Transfers (Schedule G) (7) 185, 170 .49
C8) 646,213.60
s. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: 13,014.89
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 14 8.14
11 . Total Deductions (11) 1 3 • ~ 63.03
633, 050 .57
12. Net Value of Tax Return (12)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax (14) 633, 050 .57
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 (16) 633,050.57 X 045 = 28,487.27
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) •0 0 X 15 = .0 0
19. Principal Tax Due (19 )= 28'487.27
TAx GK U1 1 l
PAYMENT
DATE
ECE PT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
05-14-2009 CD011227 1,424.36 27,062.91
TOTAL TAX CREDIT 28,487.27
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 ~1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUt~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)