HomeMy WebLinkAbout07-09-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-O60I
NOTICE OF INHERITANCE TAX
AP~RIIr~'SE#~~1!F-~,, LLOWANCE OR DISALLOWANCE
,- QF,~,D~DUCT`-IIS AND ASSESSMENT OF TAX
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STEVE GOUSE ~i.~~ ~~~'~ '~~`~' r„- ~A
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2 THIRD ST EXT ENOLA
ENOLA PA 17025
(1) .00
(2) .00
C3) .00
(4) .00
C5) 14.00
(6) .00
(~) .00
CUT ALONG T_H I S L I NE _ ---~ R_ ETA_ I N LOWER POR_ TI ON_ FOR YOUR RECO_ RDS ~--^ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE-OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE 0F: GOUSE ADELINE AFILE N0.:21 09-1192 ACN: 101 DATE: 07-05-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
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DEPARTMENT OF REVENUE
REV-1547 EX AFP 112-09)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
C8) 14.00
(9). . 00
(lo) 81.50
11. Total Deductions C11) 81.50
12. Net Value of Tax Return (12) 67.50-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14 e of Estate Subject to Tax
t V
l
N (14) 67.50-
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e
a
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
lb. Amount of Line 14 taxable at Lineal/Class A rate (16) .0 0 x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate (17) .0 0 X 12 .0 0
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) .0 0 X 15 = .0 0
19. Principal Tax Due (19?° .0 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
DATE 07-05-2010
ESTATE OF GOUSE ADELINE A
DATE OF DEATH 12-18-2009
FILE NUMBER 21 09-1192
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-03-2010
(See reverse side under Objections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TOTAL TAX PAYMENT .00
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~