HomeMy WebLinkAbout12-04-09NOTICE OF INHERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES APP~~~Q~`~"~NCE OR DISALLOIIANCE DEPARTMENT OP REVENUE
INHERITANCE TAX DIVISIDN 0~i~~i~t~1ND ASSESS~4ENT OF TAX REV-1547 EX AFP C10-09)
PO BOX 280601 t :L, v ~ CJt ~ fC ._~;i
HARRISBURG PA 17128-0601
~~9 p~'~ -(~ ~M ( _ ((,~ DATE 11-30-2009
ESTATE OF ROZMAN THOMAS J
DATE OF DEATH 02-27-2009
~'~~ ~ FILE NUMBER 21 09-0288
~~ ~ ~ COUNTY CUMBERLAND
EDMUND G MYERS ~~~~ ACN 101
JOHNSON DUFFIE APPEAL DATE: 01-29-2010
PO BOX 109 (See reverse side under Objections)
LEMOYNE PA 17043 A(ROUnt Rentitted~-
MAKE CHECK PAYABLE AND R MIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS-LINE----- -1 --RETAIN-LOITER PORTION-FOR_YOUR-RECORDS- ~--^
REV-1547 EX AFP (10-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE, OR
DISALLOMANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ROZMAN THOMAS JFILE N0.:21 09-0288 ACN: 101 DATE: 11-30-2009
TAX RETURN NAS: (X) ACCEPTED AS FILED ( )CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Estate (Schedule A) (i) 136,700.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subwit the upper portion
of this fora with your
4. Mortyages/Notss Receivable (Schedule D) (4) .00 tax payaent.
5. Cash/Bank Deposits/Misc. Personal Property (ScMdul• E) [5) 28, 551 .57
6. Jointly Owned Property (Schedule Fl (6) .00
7. Transfers (Schedule 6) (7) .00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adw. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
(~) 165,251.57
(q) 38,646.03
(io) 211.636.95
11. Total Deductions (11) 250,282.98
12. Net Valw of Tax Return [12) 85,031.41-
13. Charitable/Governwsntal Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 85.031.41-
NOTE: If an assesseent was issued previously, lines 14, 15 andior 16, 19, 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 rats (15) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate [16) 00 X 045 ° .00
17. Amount of line 14 at Sibling rate [17) O0 X 12' ° .00
18. Amount of Line 14 taxable at Collateral/Class B rats (18) .00 X 15 - .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
------- ------- -
AMOUNT PAID
DATE NUMBER INTEREST/PEN 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 DUEL
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. /~