HomeMy WebLinkAbout01-20-11_.,~.. - ~ -~~' 1'1t~DTICE OF INHERITANCE TAX
BUREau OF INDIVIDUAL TAxES APPRA'T'S~MENT, ALLOWANCE DR DISALLOWANCE
INHERITANCE TAx DIV1s1oN OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
~.~ _._ __
r~ ~ , _
DAVID J LE:DEf~~f~ANN
3425 SIMPSON FERRY RD
CAMP HILL PA 17011
(1) .00
(2) .00
(3) .00
t4) .00
c5) 37,500.00
c6) .00
(7) .00
CUT ALONG THIS L INE _ --~ - _ RETA_ IN LOWER POR_ TION_ FOR YOUR RECO_ RDS E- _ _ _ _ _ _ _ _ _ _ _ _
REV-1547 EX AFP C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OIR -~
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: JOHNSON JESSIE EFILE N0.:21 10-0415 ACN: 101 DATE: 01-10-2'011
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED __
APPRAISED VALUE I)F RETURN BASED ON: ORIGINAL RETURN
1. Reaa Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
pe~~r~sylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-1 D)
t`IOTE: To ensure proper
credit: to your account,
submit: the upper portion
of this farm with your
tax payment.
($) ___ 37,500.00
(9) 9 , 442.10
clo) .00
(11) 9,442.10
11. Total Deductions _~ 057
90
28
12. Net Value of Tax Return ( 12) _N .
,
13. CharitablelGovernmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _~ .0 0
Tax
t t
S
bj
t
t (14) 28, 057.90
14. ec
o
u
a
e
Net Value of Es _~
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 (15) 28,057.90 X 00 __ .OD
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) .00 X 12 __ . Oi0
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 __ .OID
19. Principal Ta:t Due (19)__ VOID
TAY f'RFT)TTC
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) 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" l'CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM F"(lR IPJSTRUCTIONS.
DATE 01-10-2011
ESTATE OF JOHNSON JESSIE E
DATE OF DEATH 04-04-2010
FILE NUMBER 21 10-0415
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-11-2011
(See rei~erse side under Objections)
Amount Remitted __
MAKE CHECK PAYABLE AND REI'1IT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S4UARE
CARLISLE PA 17013
~\•~~'