HomeMy WebLinkAbout06-04-10NO OF I NHER I TANCE `TAX Renr~sylvania
6x"~^~ ~~~~1 ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES F , ^ ,f.,~~ t - DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~w !€ IONS ~1ND ASSESSNENT OF TAX REV-1547 EX AFP C12-09)
PO 80X 280601 ~~~~ j~ t,,,i1i ~ ~ s~ "~'
HARRISBURG PA 17128-0601
+~p~~~..~ ~~~i` ~~ DATE 05-31-2010
GG~~ ESTATE OF HESS KAY B
. DATE OF DEATH 05-13-2009
FILE NUMBER 21 09-0535
COUNTY CUMBERLAND
JAN M WILEY ~~ ACN 101
130 W CHURCH ST ~- APPEAL DATES 07-30-2010
D I L L S B U RG PA 17 019 (See reverse side rtndtr Ob,~ec8tons)
Aaount Re~ittsd
MAKE CHECK. PAYABLE AND REMIT PAYMENT TOs
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETALN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OFs HESS KAY BFILE NO.s21 09-0535 ACN: 101 DATE: 05-31-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estato (Schedule A) C1) •0 0 NOTE: To ensure proper
2. Stocks and Bonds CSchadula B) C2) .0 0 credit to your account,
3. Closely Hald Stock/Partnership Interest (Schedule C) C3) .EEO submit the upper portion
of this form with your
4. MortpaBes/Notes Receivable (Schedule D) C4) •Q 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedulo E) C5) 5,557.94
6. Jointly Owned Property (Schedule F) C6) .0 0
7. Transfers CSchedulo G) C7) 5, t}27.02
8. Total Assets C8) 10 , 5.84.98
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg) 11,1 8.7.4 D
10. Debts/Mortgage Liabilities/Liens CSchedulo I) C10) .0 0
11. Total neductions cll) 11,187...40
12. Net Value of Tax Return C12) 602.42-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchodule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 602.42-
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect fiEures that include the total of A_ returns assess®d to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 a .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) ,~Q,~„ X 045 a .00
17. Amount of Line 14 at Sibling rate C17) _0 4 X 1 2 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 1 5 = .0 0
19. Principal Tsx Due C19): .Q 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYl1ENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS A •'CREDIT•• CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTION~~~~ ^~