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Home My WebLink About06-04-10NOTICE OF INHERITANCE TAX ~~~S~~Vl~~~~ AP LOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE BUREAU OF INDLVIDUAL TAXES ~ ~ ~:~ k INHERITANCE TAX DIVISION ~' ,,~. AND X~S~SSMENT OF TAX REV-1547 EX AFP C12-09) PO BOX 2x0601 - ~ ~ ""° ~,. ti~ HARRISBURG PA 17128-0601 {''}~";~,~~~.~~ ~~ "'~"'~ ~~ ~~ "~ '~ ' ~ ESTATE OF KELLEY2010 JACK F DATE OF DEATH 10-03-2008 FILE NUMBER 21 08-1055 TRACEY B 6RINESTAFF ~~~ COUNTY CUMBERLAND ACN 101 GIBBEL ETAL ~~~ APPEAL DATE: 07-30-2010 PO BOX 16 (Sae reverse side Wader 4hfet~ions) LITITZ PA 17543 A~ount Re~itted ~- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 CUT AL©NC THIS LINE ~'- RETAIN LOWER PORTION FOR YOUR RECORDS !'~ - - - - - r - - - ~• - - - - - ~ - - - - - - w - - - - - - - - - - - - - - - - - -~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - •• - - - - - - - - - - - - - - - - - - - - - REV-1547 EX AFP C12-091 NOTICE OF INHERITANCE TAX APPRAISEM~ENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: KELLEY JACK FFILE NO.:21 08-1055 ACN: 101 DATES 05-31-2010 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED ~~~ . APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) Ci)_,_1 9~2+ 950_ NOTE: To ensuro proper 2. Stocks and Bonds (Schedule B) (2) 23, 042.92 credit to your account, 3. Closely Held Stock/Pat~tnership 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) C5) 28,924.3 7 6. Jointly Owned Property (Schedule F) C6) .0 0 7. Transfers (Schedule G) C7) 225, 015.00 s. Total Assets C8) 469,"932.29 APPROV ED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule N) Cy)_, 35.68 2.59 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 1,32 7.65 11. Total Deductions Cil) 37, 010.24 12. Net Value of Tax Return C12) 432, 922.05 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .QQ 14. Net Value of Estate Subject to Tax C14) 432s9~2 0~5 NOTE: If an asaess~ent was issued previously, lines 14, 15 .and/or 16, 17, 18 and 19 will r®fiect figures that include the total of A_LL returns assess®d to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 .Q 0 16. Amount of Lins 14 taxable at Lineal/Class A rate C16) ~2,~~ X 045 ~ 19,481.49 17. Amount of Line 14 at Sibling rate C17) -0 ~ X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 1 5 = .0 0 19. Principal Tax Due C19)= 19,481.49 TAX CREDITS AYMENT DATE RECEIP NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 12-30-2008 CD010716 956.25 18,168.75 12-31-2009 CD012189 .00 356.49 13ALANGE of UNPAiD INTEREST/PENALTY AS OF 01-01-2010 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX PAYMENT 19,481.49 BALANCE OF TAX DUE .00 INTEREST AND PEN. 8.84 TOTAL DUE 8.84 IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.