HomeMy WebLinkAbout03-12-10pennsylvania ~
-NOTICE OF INHERITANCE TAX
P pppR~A-I~£MENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TpxES OF' D,~DUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP clz-BV)
INHERITANCE TAX DIVISION ,.
PD BOX 280601
HARRISBURG PA 17128-0601 ~;. ~~ 03-15-2010
?SRO t~A~ 12 t
r.. ~~.
C{ ~til~~ `mot
OR-'~p~~~' ~pURT
WAYNE FAILOR CLlt~:'~~~~~.,,r'~~:,1 r~, PA
APT 202
2837 N FRONT ST
HARRISBURG PA 17110
DATE KEATHE G
ESTATE OF FAILOR
DATE OF DEATH 07-31-2009
FILE NUMBER 21 09-0727
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 05-14-2010
(See reverse side under Objections )
Amount Remitted
MAKE REGISTERA OFB WI A SD REMIT PAYMENT T0:
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE_____ ~ __RETAIN_LOWER_PORTION FOR YOUR_RECO_RDS__________
"-"~--- ALLOWANCE OR
REV-1547 EX AFP C12-09~DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENT OF TAX DATE: 03-15-2010
rFnTHE GFILE N0.:21 09-0727 ACN: 101 -
ESTATE ur : YA1LUn ) CHANGED SEE ATTAC;Htu nu i L~
TAX RETURN WAS: ( ) ACCEPTED AS FILED ~ X
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL Ktlurcrv
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
.00 NOTE: To ensure proper
C1) 00 credit to your account,
C2) . submit the upper portion
C3) '00 of this form with your
.00 tax payment.
(4)
.00
c5)
79,565.35
C6)
8,000.00
~~)
87 , 565.35
~$)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: g 646.73
9 Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cioj 634.9 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) C11) 9,2 81,63
78,283.72
11. Total Deductions c12) 1 , 000.00
12. Net Value of Tax Return C13)
-elected 9113 Trusts (Schedule J)
N
283.72
77
on
13. Charitable/Governmental Bequests;
(14)
,
14. Net Value of Estate Subject to Tax
~
~
n
i
and 19 will
If an assessment was issued preve
ALL
l d to
to
assessed
re~turns
of
NOTE:
tota
that include th
reflect figures 00
ASSESSMENT OF TAX: C15)
ousal rate
t S .00 X 00 =
E x 045 =
983 .
3,477.77
p
C16)
15. Amount of Line 14 a
xable at Lineal/Class A rate
t .
77
00 X 12 = ,00
C1,)
a
16. Amount of Line 14 , 00
17. Amount of Line 14 at Sibling rate
llateral/Class B rate C18
C _
.00 x 15 -
c19)= .
3,477.77
o
18. Amount of Line 14 taxable at
19, Principal Tax Due
TAX CREDITS: DISCOUNT C+) AMOUNT PAID
PAYMENT RECEIPT
NUMBER INTEREST/PEN PAID C-)
3, 175.63
DATE 167.14
09-08-2009 CD011716
PAYMENT MUST BE MADE BY 04-30-2010*.
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
__.. .-.~ ~~~~ eTrnN OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT I 3,342.77
BALANCE OF TAX DUE 135.00
INTEREST AND PEN. .00
TOTAL DUE 135.00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU+
p REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 EX (01-10)
Pennsylvania
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
ITEM
SCHEDULE NO.
H ~ B-3
Keathe Failor
Sheila Megonnell
INHERITANCE TAX
EXPLANATION
OF CHANGES
ILE NUMBER
2109-0727
101
EXPLANATION OF CHANGES
Reduced to$00. Personal representative fees can only be claimed against probate assets.
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