HomeMy WebLinkAbout11-29-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
AF~P`I~A'I~EM~t+~T, ~~A-ILOWANCE OR DISALLOWANCE
_~ '~r" UF- DED11C7IO~NS AND ASSESSMENT OF TAX
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JOHN C OXZUSTOWIC~~ - ~ ,-`, ~ , !~?:;
104 S HANOVER ST
CARLISLE PA 17013
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C2) .00
c3) .00
c4) .00
c5) 299,844.03
C6) .00
C7) 98,329.09
CUT ALONG THIS LINE --~ --RETAIN-LOWER-PORTION-FOR-YOUR-RECORDS- ~ -----
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: DAVIDSON PATRICIA KFILE N0.:21 10-0269 ACN: 101 DATE: 11-15-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) 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 r
DEPARTMENT OF REVENUE
~'
REV-15G7 EX AFP C12-09)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
~8) 398, 173.12
c9) 21 , 648_37
clo) 187.48
C 11) 21 , 835.85
11 . Total Deduct ions 337.27
376
12. Net Value of Tax Return C12) ,
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
t to Tax
S
t
t
bj
f E (14) 376, 337.27
14. ec
e
u
s
a
Net Value o
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) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 376.337.?7 x 045 = 16,935.18
17. Amount of Line 14 at Sibling rate C17) .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)= 16,935.18
TAY f'RFTITTC
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
04-12-2010 CD012596 842.11 16,000.00
09-10-2010 CD013336 .00 93.10
DATE 11-15-2010
ESTATE OF DAVIDSON PATRICIA K
DATE OF DEATH 01-12-2010
FILE NUMBER 21 10-0269
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-14-2011
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TOTAL TAX PAYMENT 16,935.21
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTION S