HomeMy WebLinkAbout12-04-09BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX OIVISIDN
PO 80X 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPF~AISEMENT, ALLOWANCE OR DISALLOWANCE
"~~.. , 5 '~ F ; , ~D ASSESSMENT OF TAX
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Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C10-09)
DATE 11-30-2009
2009 DEC -4 PM ~= 4 ~ ESTATE OF CAREY DERYLE R
DATE OF DEATH 03-27-2008
FILE NUMBER 21 OS-0472
CHARLES E SHIELDS III ~~~ CQU~~
C COUNTY CUMBERLAND
ACN 101
6 CLOUSER RD
~~NB~AND CA..~ APPEAL DATE: 01-29-2010
MECHANICSBURG PA 17055 (See reverse side under Olljections)
Amount R~eitted ~-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE -__- -~ RETAIN LOWER POR TION FOR YOUR RECORDS ~
REV-1547 EX AFP (10-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTI ONS AND ASSESSMENT OF TA%
ESTATE OF: CAREY DERYLE RFILE N0.:21 08-0472 ACN: 101 DATE: 11-30-2009
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00
NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .0 0 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this fore with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax paywent.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 890.00
6. Jointly Ovmed Property (Schedule F) (6) 15.593.60
7. Transfers (Schedule G) (7) 658.309.36
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
[B) 674,792.96
[q) 13,242.70
(lo) 9.055.00
11. Total Deductions (11) 22,297.70
12. Nat value of Tax Return (12) 652,495.26
13. Charitable/Governasntal Bequests; Non-elected 9113 Trusts (Schedule J) (13) _n 0
14. Nat Valw of Estate Subiect to Tax (14) 6 .495. 6
NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 trill
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Awount of Line 14 at Spousal rate
16. Awount of Lins 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Aaount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Dw
TAX CREDITS:
DATE NUMBER INTEREST/PEN PAID (-)
02-25-2009 CD010946 .00
06-17-2009 CD011374 32.13-
AMOUNT PAID
00
045= 29.362.29
12 = .00
15 = .00
[19)= 29,362.29
28,000.00
1,394.42
BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-18-2009 TOTAL TAX PAYMENT 29 362.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. 236.59
TOTAL DUE 236.59
+~ 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.
(15) . 00 X
(16) A r,7~49r, 9A X
(ln nn x
(1B) .00 X