HomeMy WebLinkAbout05-17-10NOTICE OF INHERITANCE TAX pennsy van~a ~
APPRAIS~~"J~t~~- LI,~OWAN~~CEOR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES y,~~~ ~'"t. ~ t""'y',"ti'' ^~"':
INHERITANCE TAX DIVISION OF Dlt1J.61C- ~ ~ •_~~IiJI ESSMENT OF TAX REV-1547 EX AFP C12-09)
PO BOX 280601 ' (_~` ~ ~,~ ; ~{_ ~ r~ ± l^
HARRISBURG PA 17128-0601 ~ '«.-'•- +~e i'• %~ ~ t,,,r, i ....,
DATE 05-10-20'.10
~~~ ~ ~~Y 17 P ~~E~~ATE , OF BLOSER RUBYE M
DATE OF DEATH 06-23-20108
~~~~~ ~~ FILE NUMBER 21 08-08105
QRPhI~~~('~ nn~~RTCOUNTY CUMBERLAIND
NATHAN C WOLF ESQ ~R--~,~ ~;~; i~r~ ~CN 101
WOLF 8~ WOLF ~''~~~~"~'~"~ -'~~"~'C, `'`~" APPEAL DATE: 0'7-09-2010
10 W H I G H S T (See reverse side under Objections )
CARLISLE PA 17013-2922 Amount Remitted
MAKE CHECK PAYABLE AND~REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE _ ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E-~ _ _ _____
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLOSER RUBYE MFILE N0.:21 08-0805 ACN: 101 DATE: 05-10-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
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)
cl) .00
c2) 5, 014.80
c3) .00
c4) .00
c5) 3, 130 .68
c6) .00
c7) .00
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
c8) 8 , 145.48
~y) 3,510.33
clo) 17,953.09
C11) 21,463.42
11. Total Deductions C12) 13,317.94-
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14 f Estate Subject to Tax
t V
l
N (14) 13,317.94-
. ue o
e
a
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) .0 0 x 0 4 5 = .0 0
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)= .0 0
TAX CRFniTS~
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX SUE .00
INTEREST AND PAN. .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. ~
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