HomeMy WebLinkAbout05-21-10NOTICE OF INHERITANCE TAX pennsy van~a ~
~~~ ~ NCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES APPt~A~SEME~T,; -A~.,~-01
INHERITANCE TAX DIVISION OF.~:~~1ED~1;~~~ONS~ ;/AMD ASSESSMENT OF TAX REV-1547 EX AFP C12-09)
PO BOX 280601 ~ f;+ ~ "' ` `'' ' `''' - " '
HARRISBURG PA 17128-0601
~~~ ~~~ ~ ~ ~~ ~~; ~ (,~, DATE 05-17-2010
ESTATE OF EICHELBERGER JANE L
~~~~ ~~~ DATE OF DEATH 03-15-2009
aRP~,~!~~`S ~~E~C~RT FILE NUMBER 21 09-0284
COUNTY CUMBERLAND
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LISA MARIE COYNE ESQ ~~n=' ` {~~~-'~ ''-l'~ ~ ~~• ACN 101
COYNE 8~ COYNE APPEAL DATE: 07-16-2010
3 9 01 MARKET S T (See reverse side under Objections )
CAMP HILL PA 17011-4227 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 ~ _ _______________
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: EICHELBERGER JANE LFILE N0.:21 09-0284 ACN: 101 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) 243, 900.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 1,08 6.0 0 credit to your account,
.0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) L3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property tSchedule E) C5) 59,388.87
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) 56,500.00
8. Total Assets c8) 360 , 874.87
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 5 2.4 1 7.8 7
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 175.892.25
11. Total Deductions cll) 228,310.12
12. Net Value of Tax Return C12) 132,564.75
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 10,0 0 0.0 0
14. Net Value of Estate Subject to Tax C14) _ 122,564.75
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) 12 2.564.75 X 045 = 5, 515.41
17. Amount of Line 14 at Sibling rate C17) .00_ X 12 .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 ~ .0 0
C19)= 5, 515.41
19. Principal Tax Due
TAY f'DCTITTC.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
12-23-2009 CD012147 .00 5,515.41
BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-24-2009
TOTAL TAX PAYMENT 5,515.41
BALANCE OF TAX DUE .00
INTEREST AND PEN. 6.04
TOTAL DUE 6.04
* 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.