HomeMy WebLinkAbout07-06-10BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION
PO 800t 288601
HARRISBURG PA 17128-0601
~-,~ ~r,~ ~`~ f,r~"i~` ICE OF INHERITANCE TAX
NT', ALLOWANCE OR DISALLOWANCE
TAXES ~y~;~~ ~~LI._: `OF ttn~~~CTIONS AND ASSESSMENT OF TAX
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p~LEAccK t~F
QRT"~ J ~~V~~
DEBORAH F FONT
18b5 W LISBURN RD
CARLISLE PA 17015
Pennsylvania
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
DATE 06-28-2010
ESTATE OF ADKINS MARY J
DATE OF DEATH 11-17-2009
FILE NUNBER 21 lQ--0322
COUNTY CUMBERLAND
ACN 101
APPEAL DATES 08-27-2010
(See reverse side under Ob,~ectwns )
Amount Reu~itted~ ~~
MAKE CMECK PAYABLE AND REMIT PAYMENT TOs
REGISTER OF WILLS
1 COUi~THOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOU~t RECORDS
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REV-1547 EX AFP t12-09~ NOTICE OF INHERITANCE TAX APPRAISEM~ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ADKINS MARY JFILE NO.s21 10-0322 ACN: l0i DATE: 06-28-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANCED
APPRAISED VALUE OF RETURN RASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) CL) .0 0 NOTE: To ensure proper
2. Stacks and Bonds (Schedule B) C2) .0 0 credit to your account,
submit the upper portion
3. Closely Held StocklPartnership Interest CSchedulo C) C3) .0 0 of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedulo E) c5) 7 45.0 0
6. Jointly Owned Property (Schedule F) c6) 16,464.21
7. Transfers (Schedule 6) C7? '0 0
8. Total Assets C8) 17.209.21
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)~_,,~•9 3~ ?
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10)„_, •-O 0
C11) 5,937.57
11. Total Deductions I1 , 271.64
12. Net Value of Tax Return C12)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13)
14. Net Value of Estate Sub3ect to Tax C14) 11 , 271.64-
NOTE: If an assess~ent 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.
ASSESS MENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) ,~_, •.~ X 00 = • 00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) ~_„~,1.71,.6G X 045 " 507.23
17. Amount of Line 14 at Sibling rate C17) - _ OD X 12 ~ .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 ¢ .0 0
14. Principal Tax Due C19 )= 507.22
TAY f'Q GTITTS •
PAYMENT
DATE RECEIPt
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
03-29-2010 CD012530 .00 507.22
TOTAL TAX PAYMENT 507.22
BALANCE OF TAX DUE .00
INTEREST AND PEN. .Ofl
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.