HomeMy WebLinkAbout05-07-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DALE F SHUGHART
10 W HIGH ST
CARLISLE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
^~tt~R.:; ~t~~~w ~ ~~ AND ASSESSMENT OF TAX
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Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
~y DATE 05-03-2010
~Dlti SAY -7 A~ I ~ = Q~ ESTATE OF DEMCHAK MAXIM M
DATE OF DEATH 02-18-2x09
C~~ ~C FILE NUMBER 21 09-0307
P~~ J ~Q~~~T COUNTY CUMBERLAND
JR ~~~~=~~~~~~•!~ ~~~. PP. ACN 101
• APPEAL DATE: 07-02-2010
PA 17 013 (See reverse side unden Objections)
Amount Remitted
MAKE CHECK PAYABLE AND'~REMIT PAYMENT T0:
REGISTER OF WILLS'
1 COURTHOUSE SQUARIE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
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REV-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAD(
ESTATE OF: DEMCHAK MAXIM MFILE N0.:21 09-0307 ACN: 101 DATE: 05-03-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 211,000.010 NOTE: To ensure proper
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)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
credit to your account,
submit the upper portion
of this form with your
tax payment.
C8) 455, 056.32
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4 8.8 5 2.7,'5
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 2,0 3 7.4 5
11. Total Deductions C11) 50,889.80
12. Net Value of Tax Return C'12) 404, 166.52
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C'13) .0 0
14. Net Value of Estate Subject to Tax C14) 404, 166 .52
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 (15) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 4~4 . 166. 52 X 045 = 18, 187.49
17. Amount of Line 14 at Sibling rate C17) .0 0 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate C18) •0 0 X 15 = .0 0
19. Principal Tax Due C19)= 18, 187.49
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
05-14-2009 CD011235 900.00 17,100.0.
11-16-2009 CD012001 .00 187.4)
C2) . 010
c3) . 010
c 4 ) . 0'~0
c5) 77 , 279.919
c6) 8 , 674.315
c7) 158, 101 . 9~8
TOTAL TAX PAYMENT 18,187.49
BALANCE OF TAX I~UE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CRIEDIT" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS. FORM FOR INSTRUCTIONS.
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