HomeMy WebLinkAbout07-06-10..,~
,., ,,~,~, ~-~~ ~, ICE OF INHERITANCE TAX
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'~ `~ "R~T~~ NT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXE ~,T-~ ~~ ti
INHERITANCE TAX DIVISION ~C ~.~~~ 1 ~; ; b,~ ~~~1~tCTIONS AND ASSL~SSMENT 0~' TAX
PO diAt 268101
HARRISBURG PA 17128-0601
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C1.,ER~ G~ URT
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DAVID H STONE E
414 BRIDGE ST
NEW CUMBERLAND PA 17070
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QEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
DATE Ob-21-2010
ESTATE. OF SAYERS MARTHA P
DATE OF DEATH 06-04-2009
FILE NUMHER 21 09-0526
COUNTY CUMBERLAND
ACN 101
APPEAL DATES 08-20-2010
(See reverse side ender Obfectians)
A~ount Remitted ~- r
MAKE CHECK PAYABLE AND REMIT PAYMENT TOs
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~! RETAIN LOWER PORTION FOR YOU RECORDS ~ _______________
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISE ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SAYERS MARTHA PFILE NO.s21 09-0526 ACM: 101 DATE: Ob-21-2010
TAX RETURN. WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
A)
d
l
S
h
CL)
212,500.00
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..
NOTE: To ensure proper
e
u
c
e
1. Real Estate C
hodulo B)
CS
d
d B C2) .
,.
103., 443.88 crodit to your account,
c
s
on
2. Stocks an
Interest CSchedule C)
tnorshi
k/P
d St
C3) .0 0 submit the upper portion
f this form with your
p
ar
oc
3. Closely Hol
ivable CSchedule D)
R
/N
t C4) .0 0 o
tax payment.
ece
o
es
4. Mortgages
Personal Property CSchodula E)
/Misc
it
D C5) 12, 090 .27
.
s
epos
5. Cash/Bank
CSchodula F)
t
d P
O (6) 171,b14.52
y
roper
wne
6. Jointly
7. Transfers CSchodula 6) (7) 66, 004.09
C8) 565,652.76
e. Total assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9)~_ 36.4Qi9.61
L0. Debts/Mortgage Liabilities/Liens CSchedule I) C10) 2 32.7 7
C11) 36,652.38
11. Total Deductions 28, 970.38
12. Nat Value of Tax Return Cly)
13. Charitable/Governmental Bequests; Nonelected 9113 Trusts CSchedule J) C13) ~ a
t t
T
b C14) 5~8'
_:,3~
14. ax
o
jec
Net Value of Estate Su --- -
NOTE: if an assessment was issued previously, lines 14, 15 andtor 16, 17, ld and 19 Mill
reflect figures that include the total of AFL returns assessed to date .
ASSESS MENT OF TAX:
0 0 ~
0 0
.0 0
15. Amount of Line 14 at Spousal rate C15) .
X
16. Amount of Line 14 taxable at Lineal/Class A rate C16) ,~~8.,,~Q,- ~$.. X 045 = 23, 803.67
17. Amount of Line 14 at Sibling rate C17) -~ ~ 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 al Tax Due
Princi C19)~ 23,803.67
. p
rsv ~o rnrrc.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
03-04-2010 CD012420 .00 23,803.67
TOTAL TAX PAYMENT 23,803.67
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 INSTRUCTIONS. ~~