HomeMy WebLinkAbout01-20-11NOTICE OF INHERITANCE TAX pe~~CJyw~n~a ~
BUREAU OF INDIV:[DUAL TAXES ~~ -~~ISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OFf~EVENUE
INHERITANCE TAX f)IVISION ~F DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 Ex: AFP (12-10)
PO BOX 280601 ~
HARRISBURG PA 17128-0601
~~,, ~_ .
PAUL DA~~6S ESQ
2132 MARKET ST
CAMP HILL PA 17011
DATE 01-10-2011
ESTATE OF FERNBAUGH ANNA M
DATE OF DEATH 12-10-2009
FILE NUMBER 21 09-1183
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-11-2011
~ See reverse side under Obje~°tions
Amount Remitted __
MAKE CHECK PAYABLE AND REM:[T PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --~ --RETAIN-LOWER-PORTION FOR YOUR RECORDS t---
REV-1547 EX AFP (12-10) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OIR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT DF TAX
ESTATE OF: FERNBAUGH ANNA MFILE N0.:21 09-1183 ACN: 101 DATE: 01-10-2011
TAX RETURN WAS: C X) ACCEPTED AS FILED t ) CHANGED ~~
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reaa Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Clo:>ely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Note:s Receivable (Schedule D)
5. Cash/Bank. Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property tSchedule F)
7. Transfers (Schedule G)
8. Total A;~sets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses tSchedule H)
10. Debts/'Mortgage Liabilities/Liens tSchedule I)
rl) .00
(2) .00
t3) .00
t4) .00
t 5) 1 , 187.92
t6) 3,445.10
t7) .00
NOTE: To ensure proper
c:r•edii: to your a<:count,
submit: thE~ upper portion
of this form with your
tax payment.
t8) _~ 4, 633 . Cl2
t9) 11 , 369.35
clo) 488.91
tll) 11,858.26
11. Total Deductions -~ 7 , 225 . 24 -
12. Net Value of Tax Return t 12) ---
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedul.e J) t13) _,~~ .0 0
Tax
t t
b t 14) 7 , 225. 24-
14. jec
o
Net Value of Estate Su ___
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' T'AX:
15. Amount of Line 14 at Spousal rate t15) .0 0 X 0 0 ~ .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .0 0 x 04 5 i_ .0 0
17. Amount of Line 14 at Sibling rate t17) .0 0 X 12 __ .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 __ .0 0
14. Principal Tax I)ue t19)__ .00
TAY ('GGTITTC
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID t-) 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" {CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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