HomeMy WebLinkAbout01-03-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0801
RECEIVED FROM:
ADAMS H ANTHONY
49 WEST ORANGE STREET
SUITE 3
SHIPPENSBURG, PA 17257
REV-1182 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NQ, CD 013851
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
--"----- fold
ESTATE INFORMATION: sSN: 196-a2-6986
FILE NUMBER: 2109-0947
DECEDENT NAME: ZOOK JEREMIAH S
DATE OF PAYMENT: 01 /03/201 1
POSTMARK DATE: 1 2/30/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 09/22/2009
101 ~ 55.94
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTY
SEAL
CHECK#13689
INITIALS: WZ
RECEIVED BY:
55.94
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF INHERITANCE TAX pennsylvania ~
BUREAU OF INDIVIDUAL TAXES A gp~r(~:~.~IANCE OR DISALLOWANCE
~ AND ASSESSMENT DF TAX
T~I O.N
P~~iJIFC DEPARTMENT OF REVENUE
REV-1547 IX AFP Q2-30)
INHERITANCE TAX DIYISION ,
,
~,~, t.~, J ~`~.4.'J
PO BOX 280601
HARRISBURG PA 17128-0601
C~E~ ~~
o~~r~~~~s cauRT
H ANTHONY ADAMS CU~BERL,4N~ CO.. PA
49 WEST ORANGE ST STE 3
SHIPPENSBURG PA 17257
DATE 12-2D-2010
ESTATE OF ZOOK JEREMIAH S
DATE OF DEATH- 09-22-2009
FILE NUMBER 21 09-0947
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 02-18-2011
(See reverse side under Objections)
Amount Resitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
IN LOWER PORTION FOR
~ RETA
THIS LINE
CUT ALON6 YOUR RECORDS ~ _______________
REV-154 _
_
_
AFP C12-10~ NDTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE
7 EX
OF TAX OR
.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT
JEREMIAH SFILE N0.:21 09-0947 ACN: 101 DATE: 12-20-2010
ESTATE OF: ZOOK
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE DF RETURN BASED ON: ORIGINAL RETURN
284,268.60
NOTE: To ensure proper
1. Real Estate (Schedule A) C1)
DD credit to your account,
2. Stocks and Bonds CSehedule B) C2)
00 submit the upper portion
3 sely Held Stock/Partnership Interest CSehedule C)
Cl (3) . of this form with your
.
4. o
Mortgages/Notes Receivable (Schedule D) (4) .00
44,332.98 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5)
00
6. Jointly Owned Property (Schedule F) .
C6)
.00
7. Transfers (Schedule G)
I7)
Ce) 328.601.58
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
15
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSehedule H) 10.612.
C9)
34
10. Debts/Mortgage Liabilities/Liens (Schedule I) 69,124.
C10)
cll) 79,736.49
11. Total Deductions C12) 248,865.09
12.
13 Net Value of Tax Return
ritable/Governmental Bequests; Non-elected 9113 Trusts
Ch
(Schedule J) C13) .00
. a
(14) 865.09
248,
14. Net Value of Estate Subject to Tax
NOTE: If an assessatent 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.
ASSESS MENT OF TAX: .OD x 00 = .00
15. Amount of Line 14 at Spousal rate (15)
09
R65
X 045
4R
` 11,198.93
16. Amount of Line 14 taxable at Lineal/Class A rate C16) _
.
.
00
'
17. Amount of Line 14 at Sibling rate (17) .DD X 12 .
00
18. Amount of LSne 14 taxable at Collateral/Class B rate (18) .00 x 15 = .
C19)= 11,198.93
19. Principal Tax Due
IAA V~ceua~~:
PAYMENT
DATE
RECEIPT
NUMBER
DISCDUNT (+)
INTEREST/PEN PAID C-)
AMOUNT PAID
08-10-2010 CD013195 54.42- 11,253.35
BALANCE OF UNPAID INTEREST/PENALTY AS OF u1l-li-[uiu
TOTAL TAX PAYMENT 11,198.93
BALANCE OF TAX DUE .00
INTEREST AND PEN. 5.94
TOTAL DUE 5.94
^ 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.
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