HomeMy WebLinkAbout01-25-10 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
JERRY A (LOUSE
844 DOUBLING GAP RD
NEWVILLE PA 17241
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
01-19-2010
(LOUSE ELMER
11-03-2008
21 08-1167
CUMBERLAND
101
APPEAL DATE: 03-20-2010
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
E
CUT ALONG THIS-LINE- ~ RETAIN-LOWER PORTION FOR YOUR
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APP RAISEM ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX
ESTATE OF: (LOUSE ELMER EFILE N0.:21 08-1167 ACN: 101 DATE: 01-19-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) •0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) .O O credit to your account,
0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 7 3 9.0 0
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets C8) 739.00
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 5.9 7 7.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 1,6 2 2.0 0
11. Total Deductions C11) 7,599.00
12. Net Value of Tax Return C12) 6,860.00-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 6,860.00-
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 C15) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .0 0 x 04 5 = .0 0
17. Amount of Line 14 at Sibling rate C17) .0 0 X 12 = .0 0
18. Amount of Lfne 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= .0 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
NOTICE OF INHERITANCE TAX
APPRAL~.~~I,E~V~T~_,A~.,L,.OW~4NC.~ OR DISALLOWANCE
OF DEDU-'C~t'IONS'AN.~1 'ASSESSMENT OF TAX
.;~ ~~ K;
DATE
~~I~ J~~ ZS PM ~~ ~~TATE OF
DATE OF DEATH
~~~ ~~ (~~ FILE NUMBER
QRPI~'=`~"'~.I4 ~y~~~.~~T COUNTY
C~+~Ii ~r~~ ~ ~.. ~~ACN
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.