HomeMy WebLinkAbout02-28-11~ .'~ '°
NOTICE OF INHERITANCE TAX pennsylvan~a °:~: ~
~r"^~~~1~AI-S~ `' ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES }-, A~, I~ DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION " ,. DF D~ C ONS AND ASSESSMENT OF TAX REV-1547 EX AFP C12-10)
PO BOX 280601 ~,_(._,~` .. _ _.`..~
HARRISBURG PA 17128-0601
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CHARLES E PETRIE~u~;Y,f ='~~,y,.,,;'' ;l ~ 't~`, P'~,
3528 BRISBAN ST
HARRISBURG PA 17111
DATE 02-21-2011
ESTATE OF CEKOVIC ELI
DATE OF DEATH 07-29-2009
FILE NUMBER 21 09-0981
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-22-2011
(See reverse side under Objections
Amount Remitted 1
MAKE CHECK PAYABLE AND REMIT 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 C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CEKOVIC ELI FILE N0.:21 09-0981 ACN: 101 DATE: 02-2~-2nii
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real 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)
cl) .00
c2) .00
c3) .00
C4) .00
c5) 300, 000.00
c6) 100, 000.00
c7) .00
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
c8) 400 000.00
c9) .00
clo) .00
11. Total Deductions C11) .0 0
12. Net Value of Tax Return C12) 400, 000.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 400, 000.00
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 C15) 400,000.00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) _n n x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate (17) _n 0 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) .0 0 X 15 = .0 0
19. Principal Tax Due (19)=
TAX CREDITS: .0 0
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.