HomeMy WebLinkAbout11-29-10NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxES ~ ,• A~PRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION U~~ DEbGfiT'IONS AND ASSESSMENT OF TAX
PO BOX 280601 ,.
HARRISBURG PA 17128-0601 -- - ..: _`, - ~
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ROBERT P KL I NE !~~ ~~;, ~ ~ ~ ~;
714 BRIDGE ST +`~.
PO BOX 461
NEW CUMBERLAND PA 17070
Pennsylvania r •~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-09)
DATE 11-15-2010
ESTATE OF GRISCAVAGE HELEN R
DATE OF DEATH 05-24-2010
FILE NUMBER 21 10-0714
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
CUT ALONG THIS LINE --~ RETAIN LOWER PORTION FOR YOUR
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEM ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX
ESTATE OF: GRISCAVAGE HELEN RFILE N0.:21 10-0714 ACN: 101 DATE: 11-15-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 136,395.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) ,0 0 credit to your account,
0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .0 0
b. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets (8) 136 , 395.0 0
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 1.8 8 4.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3 71.10
11. Total Deductions C11) 2,255.10
12. Net Value of Tax Return C12) 134, 139.90
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedu le J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 134, 139.90
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 (15) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) ] 34. 139.90 x 045 = 6, 036.30
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 C19)= 6, 036.30
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
08-06-2010 CD013177 276.32 5,250.00
09-13-2010 CD013352 .00 509.98
TOTAL TAX PAYMENT 6,036.30
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.