HomeMy WebLinkAbout12-18-09NOTICE OF INHERITANCE TAX
APPRAIS,E1~ r4T, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TRXES - ^.n~~ a~+_~~1b~C~~ONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION ~, .t, ),'r'~7_.', ,,.
PO BOX 280601 • --• ~~•, ~ '~
HARRISBURG PA 17128-0601 ~ -~-~
Z~D9 DEC 18 A~ 11 ~ 32
CLERK C~
FRANK H KELLY ~. lO~,R~„~~', ~'~~~T
KELLY FINANCIAL 3~Q}~~~
400 BRIDGE ST STE 4
NEW CUMBERLAND PA 17070
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C10-09)
DATE 12-14-2009
ESTATE OF SLEBODNICK CORA B
DATE OF DEATH 01-04-2009
FILE NUMBER 21 09-0036
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 02-12-2010
(See reverse side under 08jections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~-1 RETAIN LOWER PORTION FOR YOUR
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REV-1547 EX AFP C10-09) NOTICE OF INHERITANCE TAX APPRAISEM ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX
ESTATE OF: SLEBODNICK CORA BFILE N0.:21 09-0036 ACN: 101 DATE: 12-14-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1] •DD NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 423,241.00 credit to your account,
OD 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) •DD tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 325.OD
6. Jointly Owned Property (Schedule F) C6) •Dp
7. Transfers (Schedule G) (7) 31,918.5D
8. Total Assets (8) 455.484.50
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 15.260.0..0
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 11,643.00
11. Total Deductions 0317 26,903.00
12. Net Value of Tax Return (12) 428,581.50
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 428,581.50
NOTE: If an assessment was issued previously,
reflect figures that include the total
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
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
18. Amount of line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
C15) • DD )(
C16) 42 8.581.50 X
C17) _ n0 X
cls) .00 X
00 = .00
045 = 19,286.17
12 = .00
15 = .00
(19)= 19,286.17
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
06-25-2009 CD011399 .00 19,286.1
TOTAL TAX PAYMENT, 19,286.17
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 n
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~/~\