HomeMy WebLinkAbout01-20-11NOTI,F~,AF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxES ~~-PPRAISEMENI-~,`~~ALLOWANCE OR DISALLOWANCE
INHERITANCE Tax DIV1s1oN ;UF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601
HARRISBURG PA 17128-0601
per~r~sylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-10)
DATE 01-10-2011
ESTATE OF BRICKNER DONALD L
'„ `~!~:'~' "' DATE OF DEATH 12-26-2009
,,
'~'~:"~ - _^ `' 1~'~ FILE NUMBER 21 10 - 1089
~, - ~ .
(~! ' ' -''~ COUNTY CUMBERLAND
CHARLES E SHIELDS YII ACN 101
6 CLOUSER RD APPEAL DATE: 03-11-2011
M E C H A N I C S B U R G P A 17 0 5 5- 9 7 3 5 ( See reverse side under Obj~ect~ions )
Amount Remitted __
MAKE CHECK PAYABLE AND REI'I:[T PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE _ -~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~- _ _ _______
REV-1547 EX AFP (12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OIR -
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BRICKNER DONALD LFILE N0.:21 10-1089 ACN: 101 DATE: 01-10-2011
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Sc:hedule 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)
(1) .00
(2) .00
(3) .00
(4) .00
(5) .00
(6) .00
(7) 77,638.23
MOTE: To ensure proper
credit: to your account,
submit: the upper portion
of this form with your
tax payment.
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral E~;penses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mort:gage Liabilities/Liens (Schedule I)
(8) .__ 77 , 638.23
(9) 15.00
(lo) .00
11. Total Deductions C11} _
~ 15.00
12. Net Value of T,ax Return (12? _
~ 77,623.23
13. Charitabl e/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13)
_ .00
14. Net Value of Estate Subject to Tax (14} -~ 77,b23.23
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflec t figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate ( 15) 77 , 623.23 X 0 0 =_ . 0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 x 04 5 °_ .0 0
17. Amount of Line 14 at Sibling rate (17) .00 X 12 =
_ .00
18. Amount. of Line 14 taxable at Collateral/Class B ra te (18) _
.0 0 }( 15 __ .0 0
19. Principal Ta;X ])ue (19}= . 00
TAX CREDITS: __
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS.
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