HomeMy WebLinkAbout12-03-10'`~! ' r-~.~ ~---~;t+~O~,I-CE OF INHERITANCE TAX
~: APPRA'hSEM~WT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAxES , r ~ ~~ DEp~U~TIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
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AMY M MOYA
5011 LOCUST LN
HBG PA 17109
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DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-04) ~
DATE 11-29-2010
ESTATE OF MILLER SANDRA J
DATE OF DEATH 06-11-2009
FILE NUMBER 21 10-0772
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-28-2011
(See reverse side under Objections
Amount Remitted -l
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
-RETAIN-LOWER-PORTION-FOR
CUT ALONG THIS LINE -~-~ -YOUR-RECORDS- E-- -- ---
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPR AISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: MILLER SANDRA JFILE N0.:21 10-0772 ACN: 101 DATE: 11-29-2010
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .0 0 NOTE: To ensure proper
C2) ,0 Q credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .0 O tax payment.
5. Cash/Bank DepositslMisc. Personal Property (Schedule E) (5) .0 0
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) C7) 655, 138.50
c8) 655, 138 .50
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 8+3 3 9.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3,7 7 7.5 7
C11) 12, 116.57
11 . Total Deductions 643, 021 .93
12. Net Value of Tax Return C12)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) 4 7 0,2 8 3.0 7
14. Net Value of Estate Subject to Tax C14) 172,738.86
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 asses sed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) 172, 738 .86 X 00 = . 00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .~ 0 x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate C17) .OQ X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= .0 0
TAY CRFr)TTQ
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .OD
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
FDR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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