HomeMy WebLinkAbout10-15-10 (2)NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~ 'AP~PRA~~tENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE rAX DIV1S1oN 0~' YS~UCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
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CHARLES E SHIELiA~~ ~I~ ~,~.
6 CLOUSER RD
MECHANICSBURG PA 17055-9735
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DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-09) r
DATE 10-11-2010
ESTATE OF DAYIS JOSEPH W
DATE OF DEATH 08-27-2009
FILE NUMBER 21 09-0823
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 12-10-2010
(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 E-
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE:
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: DAVIS JOSEPH WFILE N0.:21 09-0823 ACN: 101
-----------------
OR
DATE: 10-11-2010
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED 0N: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 52, 000.00 NOTE: To ensure proper
C2) ,0 0 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule 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) (5) 54,276.71
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
c8) 106 , 276 .71
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 14_,2 68.71
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 116.71
C11) 14,385.42
11. Total Deductions 891.29
91
12. Net Value of Tax Return C 12) ,
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
bject to Tax
S
f E
t
t
V
l (14) 91 , 891.29
14. e
u
s
a
ue o
a
Net
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 .
ASSESS MENT 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 C 16) 91 , 891 _ ?9 X 045 = 4 , 135.11
17. Amount of Line 14 at Sibling rate C17) _(10 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)= 4, 135.11
TAY f Q ~TITTC
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
11-20-2009 CD012010 202.50 3,847.50
08-10-2010 CD013193 .70- 85.84
TOTAL TAX PAYMENT 4,135.14
BALANCE OF TAX DUE .03CR
INTEREST AND PEN. .00
TOTAL DUE .03CR
* 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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