HomeMy WebLinkAbout05-28-10BUREAU OF IMDIYIDUAL TAXES
INHERITANCE TAX DIVISION
PO B~( 28®601
HARRISBURG PA 17128-0601
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;P~~~[,.`~S~~~B~RC~"'~ALLOWANCE OR DISALLOWANCE
~`~p`~' Dl! . ~~NS AND ASSESSMENT OF TAX
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BOGAR ~ HIPP LAW OFFCS
ONE W MAIN ST
SHIREMANSTOWN PA 17011
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DEPARTMENT OF REVENUE
REY-1547 EX AFP C12-09)
DATE 05-24-2010
ESTATE OF PALMER SCOTT D
DATE OF DEATH 10-28-2009
FILE NUMBER 21 09-1083
COUNTY CUMBERLAND
ACN 101
APPEAL DATES 07-23-2010
(See roeverse side antler Obfectioxs)
Amount Rsaitted ~-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS ~
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - r - - - ~ - - .. - - - - - ... - - - - r - .. - - - -' - - - - - - - •• - - - - - - - - - - - - - - - - - - - - - - - -
REV-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OFz PALMER SCOTT -DEICE N0.:21 09-1083 ACN: 101 DATE: 05-24-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedul• A) C1) .0 0 NOTE: To ensure proper
2. Stocks and Bonds CSchedul. B) C2) .0 0 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 of this form with your
4. Mortpapes/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedul. E) C5) 11 ~ 785.73
6. Jointly Owned Property (Schedule F) C6) .~•0
7. Transfers (Schedule G) C7) .0 0
B. Total assets C8) 11, 785.73
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedul• H) Cg) .0 ~
10. Debts/Mortpape Liabilities/Liens (Schedule I) C10) .0 0
11. Total Deductions C11) .0 0
785.73
11
12 . Net Value of Tax Return C 12) ,
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedul• J] C13) .0 0
14. Net Value of Estate Subject to Tax C14) 11,785.73
NOTE: If an ass~ss~snt was issued previously, lines 14, 15 and/or 16, 17 , 18 end 19 will
reflect fi0ures that include the total of ALL returns assessed to date.
ASSESS MENT OF TAX:
15. Amount of Lin• 14 at Spousal rate C15) 11 , 785 X 00 = . 00
16. Amount of Lin• 14 taxable at Lineal/Class A rata t16) -D D x 04 5 = .00
17. Amount of Line 14 at Sibling rate C17) -~ A X 1 2 = .00
18. Amount of Lin• 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
14. Principal Tax Due Clg )" .00
TaY f_Q FIITTS
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
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 DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS./