HomeMy WebLinkAbout11-08-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAIS~~!'r~'~!,-~~A{.k~~WA-~tC~ .OR DISALLOWANCE
OF DEDUCTXA~hf~ `•f!tND-'~A~ESSMENT OF TAX
cl) .00
t2) 1, 176.00
t3) .00
t4) .00
t5) 4 , 340.00
t6) .00
t7) .00
~~~~~~~--8 p, ~;DA~T„E 11-01-2010
E~~ATE OF POLM GENEVIEVE M
DATE OF DEATH 05-24-2010
~~.~~~( ~~ FILE NUMBER 21 10-0612
OR°i~!~I~~~S ~v~.~i~T COUNTY CUMBERLAND
JOHN R ZONARICH ESQ ~(~j~~"~~! ~,P~~~ r 'v`(~~ G~1CN 101
dTH FLR APPEAL DATE: 12-31-2010
17 S 2ND S T (See reverse side under Objections
HBG PA 17101 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE _ ~ --RETA_IN LOWER POR_TION_ FOR YOUR RECORDS f- _ ___ _____ _____
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR - -
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: POLM GENEVIEVE MFILE N0.:21_10-Ob12 ACN: 101 DATE: 11-01-2010
TAX RETURN WAS: tX) 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)
pennsyLvania ~ ` ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
t8) 5,516.00
t9) 1 1 , 32b . 0.0
tlo) .00
tll) 11 , 326.00
11 . Total Deductions 810.00-
5
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 t14) 5,810.00-
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 t15) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate t16) .0 0 x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate t17) .~ 0 X 12 ~ .0 D
18. Amount of Line 14 taxable at Collateral/Class B rate t18) .0 0 X 15 = .D 0
19. Principal Tax Due t19)= .0 0
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PAYMENT
DATE RECEIPT
NUMBER DISCOUNT t+)
INTEREST/PEN PAID t-) AMOUNT PAID
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~