HomeMy WebLinkAbout01-20-11N•0~~''I~~-CE OF INHERITANCE TAX
of INDIVIDUAL TAxES ~~- APPRAISE~dE?•NT, ALLOWANCE OR DISALLOWANCE
BUREAU
INHERITANCE TAX DIV'IS10N OF TyEbU'E,TIONS AND ASSESSMENT OF TAX
PO BOX 28D601
HARRISBURG PA 1712E-OE;O1
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CHARLES E SHIEL~s III
6 CLOUSE.R RD
MEC:HANICSBURG PA 17055-9735
pen~~sylvan~a ~
DEPP,F'TMENT OF REVENUE
REV-:1547 Ex AFP (12-10)
DATE 01-10-2011
ESTATE OF PRESCOTT CELKA K:
DATE OF DEATH 02-13-2010
FILE NUMBER 21 10-0165
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-11-•2011
( See reverse side under Objec~`ions
Amount Remitted __
MAKE CHECK PAYABLE AND REINIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG T_HTS LINE _ --~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS 4--
REV-1547 EX AFP C12-101 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: PRESCOTT CELKA KFILE N0.:21 10-0165 ACN: 101 _____________ _
OR -
DATE: 01-10-2011
TAX RETURN WAS: tX) ACCEPTED AS FILED C ) CHANGED M
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 130,000.00 NOTE: To ensure proper
(2) 32,567.13 credit: to your account,
2. Stocks and Bonds (Schedule B) submit: the upper portion
3. Closely Held Stock./Partnership Interest (Schedule C) C3) . ~Q of this form with your
4. MortgagesiNotes Receivable (Schedule D) (4) •d ~ tax payment.
5. Cash/Bank DepolitslMisc. Personal Property (Schedule E) C5) 17,259.37
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .0 0
t8) 179,$26.~i0
8. Total Assets _~
APPROV ED :DEDUCTIONS AND EXEMPTIONS:
9. Funeral E~:penseslAdm. Costs/Misc. Expenses (Schedule H) (9) 39 , 412.88
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 38,517.32
( 11 ) 77 ,. 930 ' 20
11 . Total Deductions ___
( 12) .101 , 896.30
12. Net Value of Tax Return -M
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _,~ 3 5,6 6 3.71
ct to Tax
bj
t
t
S
f E (14) 66,232.59
14. u
e
a
e
s
Net Value o ___
NOTE: If any 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• T'AX:
15. Amount of Line 14 at Spousal rate (15) •0 Q X 0 ~ __ .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .0 0 x 0 4 5 __ .0 0
17. Amount of Line 14 at Sibling rate (17) SO , 948.1 5 x 12 __ b, 113.78
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 15,284.44 X 15 __ 2,292.66
19. Principal Ta:x Due (19)~ 8 , 406 . 4~4
TAX t'RFTITT•S _
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
04-29-2010 lCD012675 420.32 10,687.50
TOTAL TAX PAYMENT ~_ 11,107.82
BALANCE OF TAX DUE 2,701.38CR
INTEREST AND PEN. .00
TOTAL DUE _ 2,701.38CR
* IF PAID AI=TER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" ~:CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM F=OR IIJSTRUCTIONS.