HomeMy WebLinkAbout01-03-11NOTICE OF INHERITANCE TAX
BUREAU OF INDIVI~`~jr,~d;~'; ~'-~-~~AISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISIb~rr"~' ' '' ~` t1~OF DEDUCTIONS AND ASSESSMENT OF TAX
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PO BOX 280601 ~ 1 ~- `. + . ,, ~,,
HARRISBURG PA 17128-06~1~''`'~~'` ``'
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JOHN C l,~-., ~'~~~f'~` ~-~ t, -~ pA,
104 S HANOVER ST
CARLISLE PA 17013
Pennsylvania 4 -4i
DEPARTMENT OF REVENUE
REY-1547 EX AFP C12-10)
DATE 12-27-2010
ESTATE OF GINGRICH TODD M
DATE OF DEATH 02-13-2010
FILE NUMBER 21 10-0347
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 --~ _-RETAIN_LOWER_PORTION FOR YOUR RECORDS ~-
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REV-1547 EX AFP C12-10) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: GINGRICH TODD MFILE N0.:21 10-0347 ACN: 101
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OR
DATE: 12-27-2010
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .0 0 NOTE: To ensure proper
(2) .0 0 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) L3) .0 0 of this form with your
4. Mortgages/Notes Receivable (Schedule D) t4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 5,$ 54.17
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets t8) _ 5,854.17
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 3.5 28.28
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 11,593.34
tll) 15, 121.62
11 . Total Deductions 267.45-
9
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 (14) _ 9,267.45-
.
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) .0 0 x 04 5 = .0 0
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)= .0 0
TAY f_RF11TTt
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
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. `~~~~