HomeMy WebLinkAbout01-03-11NOTICE OF INHERITANCE TAX
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INHERITANCE TAX DIVISI61ty.. OF DEDUCTIONS AND ASSESSMENT OF TAX
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DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-10)
DATE 12-27-2010
ESTATE OF KOZLOWSKI FELIX
DATE OF DEATH 10-07-2009
FILE NUMBER 21 10-0199
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 02-25-2011
(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-- _ ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E-~
REV-1547 EX AFP C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: KOZLOWSKI FELIX FILE N0.:21 10-0199 ACN: 101 __________
-OR
DATE: 12-27-2010
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
2. Stocks and Bonds (Schedule B) C2) .0 0 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion
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) C5) .0 0
6. Jointly Owned Property (Schedule F) C6) 30,399.14
7. Transfers (Schedule G) C7) .0 0
8. Total Assets C8) _~ 30 , 399.14
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cq) 8.6 0 6. 7
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 6 3.19
11. Total Deductions C11) 8, 669 .46
12. Net Value of Tax Return C 12) 21 , 729.68
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 21 , 729.68
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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 71 . 7 9.68 x 045 = 977.84
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 C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= 977.84
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
03-01-2010 CD012407 .00 .07
1191 C1CCJ I 1J l.r1AKl~tL I I'iKUUbli Ul - 11 -2011
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .07
BALANCE OF TAX DUE 977.77
INTEREST AND PEN. 19.92
TOTAL DUE 997.69
~ 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 INSTRUCTIDNS.