HomeMy WebLinkAbout02-11-11~~, ~•,~ ~.,~(~Q,I~~. OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~~'~'~^~~~-A~~R! ALLOWANCE OR DISALLOWANCE
POHBOXT280601AX DIVISION ~.~~(`~'~ ~~ r~j~p,U¢Y+IONS AND ASSESSMENT OF TAX
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HARRISBURG PA 17128-0601 -
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JENNIFER B HIPP ~~~~'~`- ~-~°~~.,a!f~l ~~;{~ ft~
1 W MAIN ST
SHIREMANSTOWN PA 17011
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-].547 IX AFP (12-10)
DATE 02-07-2011
ESTATE OF PECK SHIRLEY M
DATE OF DEATH 09-19-2010
FILE NUMBER 21 10-1145
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-C18-2011
(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
REV-1547 EX AFP C12-10~
---"-----"-- RECORDS ~--
NOTICE OF INHERIT
DISALLOWANCE ---""----"------------------ __
CE OR ----
R
A
O
OF DEDUCTIONS
ESTATE OF: PECK AND
ASSESSMENT
OF
TAX
SHIRLEY MFILE NO.:
21
10-1145
ACN: 101
DATE
TAX RETURN WAS: (X) ACCEPTED AS
FILED : 02-07-2011
C )
APPRAISED VALUE OF RETURN BASED 0N: ORIGINAL RETURN CHANGED
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) C1) .0 0 NOTE: To ensure proper
3. Closely Held Stock/Partnership Int (2) 7 6.0 0 credit to your account,
erest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D) C3) .0 0 .submit the upper portion
of thi
C4)
5. Cash/Bank Deposits/Misc. Personal Propert
(S
.00 s form with
your
'tax payment.
y
chedule E
6. Jointly Owned Property (Schedule F) ) (5) 5 3 9 0.0 0
~
7. Transfers (Schedule G) C6) 82, 132.14
c7) .00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: ~$) 87.598 14
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 8 8
10. Debts/Mortgage Liabilities/Liens (Schedule I) 0
clo) 00
11. Total Deductions
12. Net Value of Tax Return C11) _ 858.50
13. Charitable/Governmental Bequests; Non-elected 9113 Tru
t (12) -_ 8 6,7 3 9.64
14. s
s
Net Value of Estate Subject to Tax (Schedule J)
C13) - .0 0
NOTE: If an assessment was issued previously
1 C14) - 86,739 64
,
reflect figures that include the tot
l 6~ 17, 18 and 19 will
a
of
ALL
ASSESSMENT OF TAX: returns asses e
d to date.
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT
DATE DISCOUNT (+)
NUMBER INTEREST/PEN PAID C-)
11-18-2010 CD013664
195.16
c15) .00 x 00 = .00
C16)_ fib 7~9 6~ X 045 =
3,903.28
(17) ~ X 12
.00
c1s) .00 X 15 = .00
c19)_ 3, 903.28
AMOUNT PAID
,708.1
TOTAL TAX PAYMENT
__ 3, 903.28
BALANCE OF TAX DUE
_ .00
INTEREST AND PEN. __ .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS_DUE