HomeMy WebLinkAbout05-28-10___ -,~F, I ~ OF INHERITANCE TAX
A~pRAIS`~E ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES ~ .c' ,: ~ (~
INHERITANCE TAX DIVISION ,..r' ~}~; U~DV~.rIONS AND ASSESSMENT OF TAX
PO BOX 280601 '- `~'
HARRISBURG PA 17128-0601
MICHAEL CHEREWKA
624 N FRONT ST
WORMLEYSBURG
ZOO I~AY `L8 P~ I ~ Z~
CLARK ~ ~J~T
4R~~~;~~~ rJ~~ , PAS
PA 17043
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
DATE 05-24-2010
ESTATE OF HARRIS ALICE M
DATE OF DEATH 05-20-2009
FILE NUMBER 21 09-0506
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-23-2010
(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 ~
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APP
RAISEM --------
ENT, ALLOWANCE -----------------
OR
DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX
ESTATE OF: HARRIS ALICE MFILE N0.:21 09-0506 ACN: 101 DATE: 05-24-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 138, 635.37 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .0 Q credit to your account,
3.
Closely Held Stock/Partnershiplnterest (Schedule C)
C3)
•~ ~ submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •~ ~ tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 108, 771 .57
6. Jointly Owned Property (Schedule F) (6) 80,861.02
7. Transfers (Schedule G) (7) .0 0
8. Total Assets c8) 328 , 267.96
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 2 5.12 2.68
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 24,758.81
11. Total Deductions C11) 49,881.49
12. Net Value of Tax Return C12) 278, 386.47
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J] C13) .0 0
14. Net Value of Estate Subject to Tax C14) 278, 386 .47
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
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
c15) .00 x 00 = .00
c16) 278.386.47 x 045 = 12,527.39
clr] . oo x 12 = . 00
cls) .00 x 15 = .00
c19)= 12,527.39
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
08-12-2009 CD011615 578.95 11,000.00
01-15-2010 CD012244 .00 948.46
TOTAL TAX PAYMENT 12,527.41
BALANCE OF TAX DUE .02CR
INTEREST AND PEN. .00
TOTAL DUE .02CR
* 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.