HomeMy WebLinkAbout05-21-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APR,R/~,IRS6M~,MT;,-Ak~WANCE OR DISALLOWANCE
~C1F DE~~7t0'iw~ CND ASSESSMENT OF TAX
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SCOTT M DINNER ESQ ~~~~~'?~'''~ '.'~, '~'_~ (~~,
LAW OFF OF S M DINNER
3117 CHESTNUT ST
CAMP HILL PA 17011
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DEPARTMENT OF REVENUE
REY-1547 EX AFP (12-09)
DATE 05-17-2010
ESTATE OF HAVERSTOCK PAUL R
DATE OF DEATH 03-27-2009
FILE NUMBER 21 09-0367
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 _ ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E'er _
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HAVERSTOCK PAUL RFILE N0.:21 09-0367 ACN: 101 _______________
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) (1) .0 0 NOTE: To ensure proper
(2) 6,4 7 9.6 4 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 35,998.27
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) C7) 16, 000.00
CS) 58 , 477.91
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 5.4 3 5.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 31 , 399.87
(11) 36,834.87
11. Total Deductions 21, 643.04
12. Net Value of Tax Return C12)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
T
t t
b (14) 21 , 643.04
14. ax
o
jec
Net Value of Estate Su
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 .
ASSESS MENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) • 00 X 00 -- . 00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 1 , 643.04 x 045 = 973.94
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 1 5 -- .0 0
19. Principal Tax Due C19)~ 973.94
Twv re rnrrc.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
12-29-2009 CD012155 .00 973.94
05-10-2010 SBADJUST .00 •27
TOTAL TAX PAYMENT 973.94
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DU
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. (,~,r'~