HomeMy WebLinkAbout09-03-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRASSEMENT, ALLOWANCE OR DISALLOWANCE
OF DE:~IIUCTIONS AND ASSESSMENT OF TAX
-, ,
,. _
-1t r
{ ~ ' ~
CHARLES E P~`L'i~~tE -. ,' . .~~'~- ;-.,f.
3528 BRISBAN ST
HARRISBURG PA 17111
pennsylvan~a ~ ~ .
DEPARTMENT OF REVENUE
R1.V'-1547 EX AFP C12-09)
DATE 08-30-2010
ESTATE OF BLACKWELDER CLAIRE G
DATE OF DEATH 02-28-2010
FILE NUMBER 21 10-0245
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-29-2010
(See reverse side under 06 jections )
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S9UARE
CARLISLE PA 17013
CUT ALONG THIS LINE _ -~-- R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E-- _
REV-1547 EX AFP (12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLACKWELDER CLAIRE GFILE N0.:21 10-0245 ACN: 101 _______________
OR
DATE: 08-30-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 127, 698.60 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) ,0 0 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .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) (5) 174,799.67
6. Jointly Owned Property (Schedule F) (6) 99, 149.00
7. Transfers (Schedule G) (7) .0 0
t (8) 401 , 647.27
8. s
Total Asse
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedu le H) (9? 24.8 0 5.8 6
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2 8 3.9 2
(11) 25,0$9.78
11. Total Deductions _
(12) 376,557.49
12.
13. Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts _
(Schedule J) C13) _ .0 0
Subject to Tax
f E
t
t
V
l
N (14) 376,557.49
14. a
e
ue o
s
a
et _
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 d ate.
ASSESS MENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 •- .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) ~7b .557 _ 49 x 045 = 16, 945.09
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 (18) •O 0 X 15 ~ .0 0
14. Principal Tax Due (19)~ 16,945.09
TSX f'RFD7TS
PAYMENT
DATE RECEIPT
NUMBER DISCDUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
06-22-2010 CD012966 .00 16,097.84
PAYMENT MUST BE MADE BY 11-28-2010*.
TOTAL TAX PAYMENT 16,097.84
BALANCE OF TAX DUE 847.25
INTEREST AND PEN. .00
TOTAL DUE 847.25
* 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.
~1~'~