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HomeMy WebLinkAbout06-04-10BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO Bm( 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX A ~ 5 ~WANIrE QR DISALLOWANCE ~' ~ t~~~ID ASSESSMENT OF TAX penr~sylvarria DEPARTMENT OF REVENUE REV-1547 EX AFP C12-09) ~Q,~~ ~4 ~~ ~' ` DATE 05- 31- 2010 ~® ESTATE OF BURKHOLDER MARY E DATE OF DEATH 09-05-2009 FILE NUMBER 21 09-0850 COUNTY CUMBERLAND FOREST N MYERS ACN 101 137 PARK PLACE WEST ;*' APPEAL DATE: 07-30-2010 SH I PPENSBURG PA 17257 - 9212 (See reverse side under Obfed~ons) Amount Remitted ~- -~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 CUT ALONC THIS LINE ~ RETAIN LOMIER PORTION FOR YOUR' RECORDS i~ REV-1547 EX AFP C12-09) NOTICE OF INHERITANCE TAX lkPPRAISEMENT, ALL©WANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: ~1tlRKHQLDER MARY EFILE N0.:21 09-0850 ACN: 101 DATEz 05-31-2010 TAX RETURN WAS-: C)O ACCEPTED AS FILED C ) CHANGED ~~~~ APPRAISED VALUE OF RETURN BASED ONs ORIGINAL RETURN 1. Real Estate (Schedule A) C1) 152,500.00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) C2) 18, 671.06 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion of this forty with your 4. Mortgages/Notes Receivable CSchadulo D) C4) •0 0 tax paymont. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 6, 033.,85 6. Jointly Owned Property (Schedule F) C6) 2, 198.80 7. Transfers CSchadula G) (7) .OD 8. Total Assets c8) 179,403.71 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Coats/Misc. Expenses (Schedule H) Cg) 27.423.44 10. Debts/Mortgage Liabilities/Liens (Schedule i) C10) 19,439.91 11. Total Deductions C11) 46.,863..35 12. Net value of Tax Return C12) 132,540.36 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00 14. Net Value of Estate Subjoct to Tax C14) 132,540.36 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 .0 0 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 1 3? . AGO _;6 x 045 = 5, 964.32 17. Amount of Line 14 at Sibling rate C17) _d 0 X 12 = .0 0 18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 Q 19. Principal Tax Due C19)= 5, 964.32 TAX CREDITS: rArntni RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) nt -7,c_~ni n rnn~ ~~m~ .,., ~ ~~ _ ~., , TOTAL TAX PAYMENT 5,964.32 BALANCE OF TAX DUf .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. L~ `l,i~