HomeMy WebLinkAbout03-05-10BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISB':IR!: PA 17128-0601
NOTICE OF INHERITANCE TAX
"'A~'P~f~IZ'SEI#E~V~~'ALLOWANCE OR DISALLOWANCE
TAXES - '
~OF DEba~C,T~bNS AND ASSESSMENT OF TAX
r~ ,. ,.
MARK T SILLIKER ~- _. _` '.+~.
SILLIKER K REINHOLD
5922 LINGLESTOWN RD
HBG PA 17112
pennsylvarna ~~, ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
DATE 02-23-2010
ESTATE OF MILLER SUSAN A
DATE OF DEATH 08-12-2008
FILE NUMBER 21 08-0873
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-24-2010
(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 RECORDS f- _ _______________
REV-1547 EX AFP (12-09~
R
N RASSESSMENTADFOTAXCE OR
DEDUCTIONS
OF
DISALLOWANCE AND
SUSAN AFILE N0.:21 08-0873 ACN: 101 DATE: 02-23-2010
ESTATE OF: MILLER
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
Ai~PRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
00
roper
e
C1~ • p
NOTE: To ensur
1. Real Estate (Schedule A) .00 credit to your account,
2. Stocks and Bonds (Schedule B) C2~
DO submit the upper portion
Closely Held Stock/Partnership Interest (Schedule C)
3 (3) . of this form with your
. C4) .00 tax payment.
4. Mortgages/Notes Receivable (Schedule D) 34,51 5.45
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) ,0 0
. Jointly Owned Property (Schedule F) C6)
.00
/. Transfers (Schedule G)
Cn
45
515
34
c8) .
,
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Estate Subject to Tax
Iy~ 239.00
Clo) .00
Non-elected 9113 Trusts (Schedule J)
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
17. Amount of Line 14 at Sibling rate
cil) 239.00
Clz) 34,276.45
C13) . 00
C14~ 34,276.45
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-)
05-18-2009 CD011266 .00
02-16-2010 SBADJUST .00
00 = .00
045 = 9.00
12 = .00
15 = 5,111.47
C19~= 5, 120 .47
,120.47
4.21
TOTAL TAX PAYMENT 5,120.47
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
C15) . 00 X
C16) 200.00 X
Cln .00 x
C18) 34,076.45 X
AMOUNT PAID
~ 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. (r^~Jr