HomeMy WebLinkAbout07-06-10,~. ~I INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~~ ~ `~L~WANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~~~ f~~A~~~i AND AS~~$SMENT O~ TAX
PO BOX 280601
HARRISBURG PA 17128-0601
2DlO.iUL -6 P~ 2~ 19
Ct~Ri~ ~~
QRPHA~'~1'S ~~URT
MICHAEL CHEREWKA ES~w~~~~`.~'~'~~~ ~`'~ . P
624 N FRONT ST
WORMLEYSBURG PA 17043
pe~n~ylvania.
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
DATE 06-21-2010
ESTATE OF BARGE ROBERT H
DATE OF DEATH 02-09-2009
FILE NUMBER 21 09-0401
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-20-2010
(See reverse side render Ob~ns)
Amount Remitted ~-
HAKE CHECK'PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS ~,INE ____~ __RETAIN_LOWER_PORTION
FOR
YOUl~
RECORDS
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REV-1547 EX AFP Ci2-09) NOTICE OF INHERITANCE TAX APP _
_
RAISEM~ENT, ALLOWANCE ------------------
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BARGE ROBERT HFILE N0.:21 09-0401 ACN: 101 DATES 06-21-2010
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) C2) .0 0 credit to your account,
3. Closely Hold Stock/Partnership 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) 4 2 9.64
6. Jointly Owned Property (Schedule F) C6) .0 0
7. Transfers (Schedule 6) (7) .0 0
8. Total assets C8) 429.64
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4 2 4.64
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 6 6 8.67
11. Total Deductions C11) 1,098.31
12. Net Value of Tax Return C12) 668.67-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) __~ .0 0
14. Net Value of Estate Subject to Tax C14) 668.67-
NOTE: If an assessment was issued previously, lin®s 14, 15 andror 16, 17 , 18 and 19 will
reflect figures that include the total of A_ 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 tinsel/Class A rate C16)~~ ~ _ DD x 045 _ . 00
17. Amount of Line 14 at Sibling rate C17) ~ _ DO 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)= .0 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 PAYMENT .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 INSTRUCTIONS~,~