HomeMy WebLinkAbout12-03-10NOTICE OF INHERITANCE TAX
r,'- Ap'PRA~'S~1rNT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES -,-.: ,pF IjEp~1CTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION .'- ' _~'
PO BOX 280601 ' ''~ `-=~'.1 ~'_.I~i `.,i~ ,`~ ~. .:
HARRISBURG PA 17128-Ob01
GREGORY S CH ~'{~~~~" r~`'. ~ --
17 S 2ND ST
6TH FL
HARRISBURG PA 17101
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CUT ALONG THIS LINE _ --i __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: LARSEN ANN GFILE N0.:21 10-0446 ACN: 101 DATE: 11-29-2010
TAX RETURN WAS: tX) ACCEPTED AS FILED t ) 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 tSchedule 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)
t2) .00
t3) .00
t4) .00
t5) 323, 697.00
t6) 8,833.00
t7) 16,941.00
~~
pennsylvanla ~ y:
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) 349,471.00
t9) 33,309.00
tlo) 1,525.00
(11) 34,834.00
11. Total Deductions 637.00
314
12. Net Value of Tax Return C12) ,
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) t13) .0 0
14. Net Value of Estate Subject to Tax t14) 314, 637.00
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) .00 X 00 = .00
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) 1 44 .432.00 x 12 17, 332.00
18. Amount of Line 14 taxable at Collateral/Class B rate t18) 170,206.00 X 15 = 25,531.00
t19)= 42,863.00
19. Principal Tax Due
TAY (`DGTITTC
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
06-15-2010 CD012921 2,105.26 40,000.00
09-16-2010 CD013372 .00 863.00
DATE 11-24-2010
ESTATE OF LARSEN ANN G
DATE OF DEATH 03-23-2010
FILE NUMBER 21 10-0446
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-28-2011
(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 42,968.26
BALANCE OF TAX DUE 105.26CR
INTEREST AND PEN. .00
TOTAL DUE 105.26CR
* 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. ~