HomeMy WebLinkAbout11-12-10,_„_,~:,,,..., -•. - ~ -~.°° NOTICE OF INHERITANCE TAX pennsylvan~a ~
`~ -°~ APPI~cISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL ;~'~4~(~,S - ~ , ?
INHERITANCE TAX DIVISION ~ „!, .I :_, _, t . Q'F DEDUCTIONS AND ASSESSMENT OF TAX REV'-1547 EX AFP C12-04)
PO BOX 280601
HARRISBURG PA 17128-0601
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ROGER L A1n15~tC`O~~T
1038 ROCKLEDGE DR
CARLISLE PA 17015
ESTATE OF AMSBAUGH MAE A
DATE OF DEATH 09-Ob-2009
FILE NUMBER 21 09-0917
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: O1-Oi7-2011
( See reverse side under Ob, jections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --i RETAIN LOWER PORTION FOR YOUR RECORDS f---
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: AMSBAUGH MAE AFILE N0.:21 09-0917 ACN: 101
OR
DATE: 11-08-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) •0 O credit to your account,
0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) . 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) t5) 9,37 6.3 7
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets (8) _ 9 , 376.37
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 7.14 7.8 3
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2,139.0 0
11. Total Deductions (11) _ 9,286.83
12. Net Value of Tax Return C12) _ 8 9.54
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) (13) _ .0 0
14. Net Value of Estate Subject to Tax (14] _ 8 9.5 4
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a nd 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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 89.54 x 045 = 4.03
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 rate (18) .0 0 X 15 .0 0
19. Principal Tax Due (19)= 4.0 3
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
11-01-2010 SBADJUST .00 4.10
TOTAL TAX PAYMENT 4.03
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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