HomeMy WebLinkAbout11-12-10f_,~,r,,~~,r ,, _ ~ ,.. NOTICE OF
'
~ INHERITANCE TAX pennsylvan~a
WANCE OR DISALLOWANCE ~ ,
T DEPARTMENT OF REVENUE
~~ISEMENT, ALLO
APB-
A
BUREAU OF INDIVIDUAL .-
X~
INHERITANCE TAX DIVISION i`` t ;.;~; R-~ ,. `~~ DEDUCTIONS AND ASSESSMENT OF TAX REV'-1547 EX AFP C12-09)
PO BOX 280601 ,,
~~ '
HARRISBURG PA 17128-0601
~~~~ t~~ ~ ~ f'Fs l~~ ' 4 DATE 11-08-2010
~' ~ ~ ~ ~ ~'
f ~w `' i r
GEORGE W F~ t~~'fi~'R' `F S Q``~ _
909 E CHOCOLATE AVE
HERSHEY PA 17033
ESTATE OF FURST DOUGLASS E
DATE OF DEATH 12-08-2009
FILE NUMBER 21 09-1158
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-07-2011
(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 F- -- ----------------
- - - - - - - - - - - - - - -- - - - - -
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: FURST DOUGLASS EFILE N0.:21 09-1158 ACN: 101 DATE: 11-08-2010
TAX RETURN wAS: C X) ACCEPTED AS FILED t ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds tSchedule 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 tSchedule 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 tSchedule I)
tl) 112, 959.00
t2) 33, 733.33
t3) .00
t4) .00
t5) 43,873.93
t6) 872.00
t~) 278, 201 .53
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
t8) 469,639.79
t9) 11 , 469.63
tlo) 2, 906.00
11. Total Deductions tll) _ 14,375.63
12. Net Value of Tax Return t12) _ 455,264.16
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) t13) _ .0 0
14. Net Value of Estate Subject to Tax (14) 455,264.16
_
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 C15) 114,784.00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .0 d x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate t17) 340.480.16 x 12 = 40,857.62
18. Amount of Line 14 taxable at Collateral/Class B rate t18) .0 0 X 15 .0 0
19. Principal Tax Due (19)= 40,857.b2
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT t+)
INTEREST/PEN PAID t-)
AMOUNT PAID
09-07-2010 CD013323 .00 40,857.62
TOTAL TAX PAYMENT 40,857.62
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.