HomeMy WebLinkAbout11-13-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 1]128-Ofi01
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1182 EX111-981
NO. CD 011987
NAZAY KRISTOFER
703 HALDEMAN BLVD
NEW CUMBERLAND, PA 17070
rom
ESTATE INFORMATION: SSN:
FILE NUMBER: 2108-1198
DECEDENT NAME: NAZAY T SANDRA
DATE OF PAYMENT: 11/13/2009
POSTMARK DATE: 1 1 /10/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 6/2008
REMARKS: RECEIPT TO ATTY
CHECK# 0099
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 54,072.71
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY
54,072.71
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
;~.~ OB FMENT OF REVENUE
~~~(~~ E ~~F INHERITANCE TAX
^, \.-.
A, ~§€ T,`ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
~9 NOY 13 AM
CLERK C~
~RQ~~C (~.I~~~F,
~UMBERLA; -; CO..
THOMAS E FLOWER
SAIDIS FLOWER LINDSAY
2109 MARKET ST
CAMP HILL PA 17011
REV-1547 EX AFP (01-09)
DATE 10-26-2009
ESTATE DF NAZAV T S
DATE OF DEATH 11-16-2008
FILE NUMBER 21 08-1198
`COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 12-25-2009
(See reverse side under Objections)
Anount Remitted p~/2 -7
MAKE CHECK PAYABLE AND REMIT PAYMENT TD:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ---- ~ RETAIN LOWER PORTION FOR YOUR RECORDS (--~
REV-1547 EX AFP CO1-09J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF NAZAY T S FILE NO. 21 08-1198 ACN 101 DATE 10-26-2009
TAX RETURN WAS: (X) AC CEPTEO AS FILED C ) CHANGED
K CSEKVAIIUN 1:UNGEKNSNti hUIURE INTEREST - SEE REVERSE
APPRAI SED VALUE DF RETURN BASED ON: ORIGINAL AND SUP PLEM ENTAL RETURN N0. O1
1. Real Estate (Sehadule A) (1) 166,000.00 NOTE: To insure proper
2. Stocks and Bands (Sehadule B) (2) 1.035.69 credit to your account,
3. ClosalY Hald Stack/Partnership Intaresi (Schedule C) (3) .00 submit the upper portion
o} this form with your
4. Mo rt gaeas/Notes Receivable (Sehadule D7 (4) .00 tax payment.
5. Cash/Bank DeposSts/Misc. Personal Property (Schetlule E7 (5) 26.510.94
6. Jointly Owned Property (Schetlule F) (67 •00
7. Transfers (Schedule G] (7) .00
e. Total assets (B) 193,546.63
APPROVED DEDUCTIONS AND EXEMPTIONS:
35,942.97
9. Funeral Expanses/Adm. Costs/MSsc. Expenses (Schedule H) (9)
10. Oab is/Mort gaga Liabilities/Liens (Sehadule I) (30) 71.283.46
11. Total Deduef ions (11) In7.J76.G~
12. Net Value of Tax Return (12) 86,320.20
13. Charitable/Governmental Bequ as ts; Non-elected 9113 Trus ts (S ehadule J7 (137 .00
14. Net Value of Estate Subieet to Tax (14) 86,320.20
NOTE: If an assessment was issued previously. linos 14, 15 and/or 16, 17 , 28 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 (15) •00 X 00 __ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 79,982.20 X 045 = 3,599.20
17. Amqunt of Line 14 at Sibling rate ()7) 6,338.00 X 12 : 760.56
IB. Amount of LS ne 14 taxable at Call ataral/Class H rate (18) •DO X 15 _ .00
19. Principal Tax Due ()9). 4,359.76
TAX CRFOTTSe
DATE
NUMBER LOU +
INTEREST/PEN PAID (-) gMOUNT PAID
08-25-2009 (0011671 .00 334.89
INTEREST IS CHARGED THROUGH 11-10-2009
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 334.89
BALANCE OF TAX DUE 4,024.87
INTEREST AND PEN. 47.84
TOTAL DUE 4,072.71
~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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