HomeMy WebLinkAbout05-21-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAI~~M.~IalTr~r~l.~68WANCE OR DISALLOWANCE
~~ Q~ `I~'~D11CfItl~1~S `~-ND ASSESSMENT OF TAX
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1817 CREEKVIEW COURT ~`''~~ ~ `"" ~ .. ,_
NEW CUMBERLAND PA 17070
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DEPARTMENT OF REVENUE
REV-1,547 EX AFP (12-09)
DATE 05-17-2010
ESTATE OF JASEK LOIS G
DATE OF DEATH 06-28-2007
FILE NUMBER 21 07-0707
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-16-2010
(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 E~
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: JASEK LOIS GFILE N0.:21 07-0707 ACN: 101
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OR
DATE: 05-17-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) •0 0 NOTE• To ensure proper
2. Stocks and Bonds (Schedule B) (2) , 51.6 8
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 •tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 8,34 9.0 7
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets (8) 14, 100 .75
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (y) 8.10 2.0 5
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0
11. Total Deductions C11) 8, 102.05
12. Net Value of Tax Return (12) 5, 998.70
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 5, 998.70
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 (16) 5. 998.70 x 045 = 269.94
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 (19)= 269.94
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
12-30-2009 CD012162 .00 269.94
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-31-2009
TOTAL TAX PAYMENT 269.94
BALANCE OF TAX DUE .00
INTEREST AND PEN. 27.87
TOTAL DUE 27.87
~ 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. ,~