HomeMy WebLinkAbout09-03-10NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxES - APPRAI-S'EMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION O'F' DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
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LEMOYNE PA 17043
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DEPARTMENT OF REVENUE
RFV-1547 EX AFP C12-09)
DATE 08-30-2010
ESTATE OF HAZEN GERALDINE M
DATE OF DEATH 09-20-2009
FILE NUMBER 21 09-0888
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-29-2010
(See reverse side under O6!jections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 C~URTH~USE SQUARE
CARLISLE PA 17013
CUT ALONG THIS-LINE ---_ --! R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ _
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HAZEN GERALDINE MFILE N0.:21 09-0888 ACN: 101 _______________
OR
DATE: 08-30-2010
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 Held Stock/Partnership Interest (Schedule C) (3} .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) 8 4 2.36
6. Jointly Owned Property (Schedule F} C6) 9 9 2.9 6
7. Transfers tSchedule G) C7} 218, 729.14
8. Total Assets c 8)
. 220 , 564 .46
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 14,4 6 0.18
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 3,26 9.9 8
11. Total Deductions X11} _ 17, 730.16
12. Net Value of Tax Return C12) 202,834.30
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _ .0 0
14. Net Value of Estate Subject to Tax C14) 202,834.30
NOTE: If an assessment was issued previously, lines 14, 15 and/or lb, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to d ate.
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 Lineal/Class A rate C16) 70? . R34 _ ~fl x 045 = 9, 127 .54
17. Amount of Line 14 at Sibling rate C17} _0 0 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 _ .0 0
19. Principal Tax Due C19)= 9, 127.54
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
12-15-2009 CD012117 263.16 5,000.00
Ob-18-2010 CD012959 .00 3,864.39
TOTAL TAX PAYMENT 9,127.55
BALANCE OF TAX DUE .O1CR
INTEREST AND PEN. .00
TOTAL DUE .O1CR
~ 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.