HomeMy WebLinkAbout02-05-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
~~1l~tfitS~M'E~;~~k~..OWANCE OR DISALLOWANCE
~iF -~~n`~~F~'p~ AND ASSESSMENT OF TAX
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SALZMANN HUGHES
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CARLISLE PA 17015
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DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
DATE 02-01-2010
ESTATE OF JACOBY RICHARD J
DATE OF DEATH 12-21-2008
FILE NUMBER 21 09-0094
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-02-2010
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT-ALONG-THIS-LINE---- ~ -RETAIN LOWER PORTION FOR-YOUR
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: JACOBY RICHARD JFILE N0.:21 09-0094 ACN: 101 DATE: 02-01-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) 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) (2) 2,2 0 9.98 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) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) c5) 193,772.12
6. Jointly Owned Property (Schedule F) c6) .0 0
7. Transfers (Schedule G) C7) 33,402.60
8. Total Assets c8) 229 , 384.70
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) c9) 16.7 2 8.41
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 2,17 4.74
11. Total Deductions C11) 18, 903.15
12. Net Value of Tax Return C12) 210,481.55
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 210,481.55
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) 210.481.55 x 045 = 9,471.67
17. Amount of Line 14 at Sibling rate C17) .n 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 (19)= 9,471.67
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
03-13-2009 CDO11001 473.58 9,000.00
01-25-2010 REFUND .00 1.91-
TOTAL TAX PAYMENT 9,471.67
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.