HomeMy WebLinkAbout08-20-10,,, NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL ~A~~s. ~-` ~~'~' -~41~.f5EMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION - ' - ~ ,'OF `='DEDUCTIONS AND ASSESSMENT OF TAX
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HARRISBURG PA 17128-0601
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WILLIAM M ~-F'~~~L~$-E FtEER ' '
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CARLISLE PA 17013
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DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09)
DATE 08-16-2010
ESTATE OF SHUFFLEBARGER MARTHA J
DATE OF DEATH 09-04-2009
FILE NUMBER 21 09-0860
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-15-2010
(See reverse side under Objections )
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --~ _-RETAIN-LOWER_PORTION-FOR -YOUR_RECORDS- ~- -- ---
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMEN T, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHUFFLEBARGER MARTHA JFILE N0.:21 09-0860 ACN: 101 DATE: 08-16-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 140, 000.00 NOTE: To ensure proper
(2) 99, 006 .28 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest tSchedule C) C3) ,0 0 of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 54,275.76
6. Jointly Owned Property (Schedule F) C6) 89,377.58
7. Transfers (Schedule G) (7) .0 0
(8) 382, 659.62
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 32.081.0 9
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 2,34 0.6 0
(11) 34 , 421.69
11 . Total Deductions 237.93
34$
12. Net Value of Tax Return C12) ,
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax (14) _ 348 , 237.93
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) .00 )( 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 34 8 ,237.93 x 045 = 15, 670.71
17. Amount of Line 14 at Sibling rate C17) _ 00 X 12 = . 00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= 15,670.71
TeY raFnrTC~
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
10-28-2009 CD011907 783.54 17,000.00
TOTAL TAX PAYMENT 17,783.54
BALANCE OF TAX DUE 2,112.83CR
INTEREST AND PEN. .00
TOTAL DUE 2,112.83CR
* 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.
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