HomeMy WebLinkAbout09-18-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES -,~.~~P,PRAIS MF~~NT,.,~ILLOWANCE OR DISALLOWANCE „~
INHERITANCE TAX DIVISION ~ y0~; DE~UCTION$ AND ASSESSMENT OF TAX
PO BOX 280601 _
HARRISBURG PA 17128-0601 ~,~~..~~ i - REV-1547 EX AFP (01-09)
DATE 09-15-2009
~~~!~ J~~ ~ S ~,~ ,~. 2 `1 ESTATE OF KL I NE J F
DATE OF DEATH 09-08-2008
FILE NUMBER 21 08-1025
~4 F '~~' ~,r COUNTY CUMBERLAND
JOHN S DAVIDSON U~"' if ~ ^ u!-ti ACN 101
320 W CHOCOLATE AVE ~~~~~~- '~`', rf~, APPEAL DATE: 11-14-2009
HERSHEY PA 17033-0437 (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 ~
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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 KLINE J F FILE NO. 21 08-1025 ACN 101 DATE 09-15-2009
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) 504,570.58 credit to your account,
.00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 649,861.38
6. Jointly Owned Property (Schedule F) (6) 14,643.76
7. Transfers (Schedule G) (7) 149, 909.47
8. Total Assets (g) 1 , 318 , 985.19
APPROVED DEDUCTIONS AND EXEMPTIONS: 24,398.50
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
11. Total Deductions (I1) 24.398.50
12. Net Value of Tax Return ( 12) 1 , 294, 586.69
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 1,294,586.69
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
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B
19. Principal Tax Due
T\T TI..
993, 167.38
(15) X
(16) 301,419.31 X
(17) .00 X
rate (18) • 00 X
00 _ .00
045= 13,563.87
12 _ .00
15 _ .00
C19)= 13,563.87
~~`PAYMENT~V
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
04-21-2009 CD011139 .00 13,563.87
^ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 13,563.87
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00 ,j
IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
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