HomeMy WebLinkAbout01-15-10NOTICE OF INHERITANCE TAX Pennsylvania ~
.APPI~/!-ISEMENT,•"?ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION - -''OF II~DUCYIQIV$ AND ASSESSMENT OF TAX REV-1547 EX AFP (12-09)
PO BOX 280601 • .
HARRISBURG PA 17128-0601 ~ - `-~ "~
2~'~ ~ ~ ~ ~~'~~ ~~ DATE 01-13-2010
ESTATE OF MAYHEW FRANCIS X
c~~R~s ~F
ORPH~i'S ~0~1R.'
JOHN C OSZUSTOWICZ (',~) ~~r~~ ~~~~~ t~., PP.
J C OSZUSTOWICZ LAMI- D~C ~~ ~r
104 S HANOVER ST
CARLISLE PA 17013
DATE OF DEATH 08-19-2008
FILE NUMBER 21 09-0649
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-14-2010
(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 t--~
------------------------------------------------------ ----
---------------------- -----------
REV-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: MAYHEW FRANCIS XFILE N0.:21 09-0649 ACN: 101 DATE: 01-13-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
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)
cl) .00
C2) .00
c3) .00
C4) .00
c5) 1,589.80
C6) .00
Cn .00
NOTE: To ensure proper
credit to your account,
submit the upper portior
of this form with your
tax payment.
8. Total Assets (e) 1 , 589.80
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) lq) 2.076.7F:
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 67.18
11. Total Deductions X11) 2, 143.93
12. Net Value of Tax Return C12) 554.13-
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 554.13-
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a nd 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 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .00 x 04 5 = .00
17. Amount of Line 14 at Sibling rate C17) .00 X 1 2 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 1 5 - .00
19. Principal Tax Due C19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE
NUMBER
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.