HomeMy WebLinkAbout06-04-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
Pa daoc 28obo1
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX Pennsylvania
~;,~ ~, , '~ LLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
F ~ ~~~ /-N~ ASSESSMENT OF TAX REV-1547 EX AFP C12-09)
~~ ~~~ ~
~U ~ ~ ~~ ~ 4 ~~ ~ i ~ '
MARVIN BESHORE ESQ ~..~
130 STATE ST
PO BOX 946
HBG PA 17108-0946
DATE 05-31-2010
ESTATE OF SHELLENBERGER ROMAINE M
DATE OF DEATH 10-01-2009
FILE NUMBER 21 10-0129
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-30-2010
(See reverse side under Objections)
Amount R•uitted ~-~
MAKE CNECK'PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON~i THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEM!ENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSE$~SMENT OF TAX
ESTATE OF: SHELLENBERGER ROMAINE MFILE N0.:21 10-0129 ACN: 101
OR
DATE: 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) C1) •0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .0 0 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 subsit the upper portion
of this form with your
4. MortBapos/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .0 0
6. Jointly Owned Property (Schedule F) Cb) 3, 232.37
7. Transfers (Schedule G) (7) .0 0
8. Total Assets Ca) 3 , 232.37
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg) 2.04 7,_; 14
10. Debts/Mortgaea Liabilities/Liens (Schedule I) C10) 37 6.78
11. Total Deductions C11) 2,423.92
12. Net Valus of Tax Return C12) 808.45
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) ~_
14. Net Value of Estate Subject to Tax C14) 808.45
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 C15) .0 0 X 0 0 s .0 0
ib. Amount of Line 14 taxable at Lineal/Class A rate C16) AD8 _ 4~ x 045 ~ 36.38
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)= 36.38
TAX CREDITS:
rnrntn~ rct~tarl Di5000NT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
02-09-2010 CD012339 .00 36.38
TOTAL TAX PAYMENT 36.38
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 INSTRUCTIONSt(~~
GI/