HomeMy WebLinkAbout02-05-10BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
Pennsylvania ~
NOTICE OF INHERITANCE TAX
,,q~~,~pp~~ ~~`~1~EENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
TAX~,~- ~ r "''~AP~,;~~~I~aUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP a2-o9)
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KENNETH F LEWI ~~Y~~3t.;..~'vN +,..,`',
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1ST FLR
1101 N FRONT ST
HBG PA 17102
DATE 01-19-
ESTATE OF JACOBS ANGELA H
DATE OF DEATH 11-03-2008
FILE NUMBER 21 08-1125
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-20-2010
(See reverse side under Objections )
Amount Remitted
MAKE REGISTER OFB WILL SD REMIT PAYMENT T0:
1 COURTHOUSE SQUARE
CARLISLE PA 17013
~ RETAIN LOWER PORTION FOR YOUR__R_E_C_O_R_D_S________
CE
6 THIS LINE --------
CUT ALON
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A
R
R
N
__
OR
_
DEDUCTIONS AND
REV-1547 EX AFP (12-09~DISALLOWANCE
OF TAX
OF
ASSESSMENT DATE: 01-19-2010
ANGELA HFILE N0.:21 08-1125 ACN: 101
ESTATE OF: JACOBS
ACCEPTED AS FILED
C
) CHANGED
TAX RETURN WAS: CX)
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
C1)
.0 0
NOTE: To ensure proper
t
1. Real Estate (Schedule A)
(2) .00 ,
credit to your accoun
submit the upper portion
2. Stocks and Bonds (Schedule B)
(Schedule C) C3) .00 of this form with Your
3. Closely Held Stock/PartnershipInte rest C4) ,00 tax payment.
4. Mortgages/Notes Receivable (Schedule D)
(Schedule E) 10,539.55
5. Cash/Bank Deposits/Misc. Personal Property C6) ,00
6. Jointly Owned Property (Schedule F) C7) 349,8 59.54
7. Transfers (Schedule G) Ca) 360,399.09
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
C9) 8 , 356 .82
c1o) .00
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Nonelected 9113 Trusts (Schedule J)
t to Tax
cll) 8,356.82
t12) 352,042.27
C13) --
C14) 352,042.27
and 19 will
ue* value of Estate Subiec ( 17 18
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
A ount of Line 14 at Sibling rate
lines 14, 15 and/or 1 , ~
of ALL returns assessed to date,
17. m
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS: DISCOUNT c+)
PAYMENT RECEIPT
DATE NUMBER INTEREST/PEN PAID C-)
792.10
ni_3n-2009 CD010837
.00 x
c15)
C16) z~ 9 042.27 X
C17) . 00 X
.00 X
C18)
AMOUNT PAID
00 = .00
045 = 15,841.90
12 = .00
15 = .00
c19)= 15,841.90
TOTAL TAX PAYMENT 16,992.10
BALANCE OF TAX DUE 1,150.20CR
INTEREST AND PEN. .00
TOTAL DUE 1,150.20CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE AF REFUND.DSEEIREVERSECSIDEAOFATHISEFORM FOR)INSTRUCTIONS.DUE ~~
o~
~.,e rei rail ATLON OF ADDITIONAL INTEREST.