HomeMy WebLinkAbout06-09-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 014556
SCHAFFNER LORENA A
503 MILL RACE ROAD
CARLISLE, PA 17013
---'---- fold
ESTATE INFORMATION: SSN: 5~s-42-si 35
FILE NUMBER: 2110-0495
DECEDENT NAME: FORTNEY MARY H
DATE OF PAYMENT: 06/09/201 1
POSTMARK DATE:
couNTY: 06/08/201 1
CUMBERLAND
DATE OF DEATH: 05/04/2010
REMARKS:
CHECK#1536
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
REV-1162 EX(11-96)
5259.36
GLENDA EARNER STRASBAUGH
INITIALS: CJ
RECEIVED BY:
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE DF INHERITANCE TAX penns~ilvania ., ~
BUREAU OF INDIVIDUAL TaxES APP T, t-~~~( I~NCE OR DISALLOWANCE
INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE ~
Po Box zao6B1 O ~~~T~IINSr14~~iD ASSESSMENT OF TAX
~~~~~ t : >r~!..utJ REV-1547 EX AFP (12-10) ~-
HARRISBURG PA 17128-0601 o--
~.`t"~~ ~~~ _9 1 fs ~) i :DATE 06-07-2011
ESTATE OF FORTNEY MARY H
M CnK ~,y~ DATE OF DEATH 05-04-2010
ORP~N~S ~UR~ FILE NUMBER 21 10-0495
JANE M ALEXANDER WwrgE~~,.J~~ (;~„ ~ ACNNTY CUMBERLAND
148 S BALTIMORE ST 101
APPEAL DATE: 08-06-2011
D I L L S B U R G PA 17 019 (See reverse side u~tder 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
-------------------------------------- RECORDS ~-
_
------------
REV-1547 EX AFP C12-10) NOTICE OF INHERITANCE TAX APPRAISEMENT
ALLOWANCE
_
--------------
,
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX OR
ESTATE OF: FORTNEY MARY HFILE N0.:21 10-0495 ACN:
101
DAT
E: 06-07-2011
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAI SED VALUE OF R
ETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 95, 000
00
2. Stocks and Bonds (Schedule B) . NOTE: To ensure proper
3. C2)
Closely Held Stock/Partnership Interest (Schedul
C) .00 credit to your account,
submit the up
er
4. e
(3)
Mortgages/Notes Receivable (Schedule D)
C4) .00
00 p
portion
of this form with your
5.
Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .
11,139.0 7 tax payment.
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers <Schedule G) C7) 67, 729.71
8. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS: ($) 173,868 78
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) ? 7
~
10. (g)_
Debts/Mortgage Liabilities/Liens (Schedule I) C10) ifl
440
6,086.08
11. Total Deductions
12.
Net Value of Tax Return (11) 28,526.58
13.
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule c12)
J) 145,342.20
14.
Net Value of Estate Subject to Tax (13)
.00
(14) 145,342.20
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16
i7 18
,
,
reflect figures that include the total of ALL returns and i9 will
ASSESSMENT OF TAX: -' assessed to date.
15. Amount of Line 14 at Spousal rate C15) 00
00 =
16.
Amount of Line 14 taxable at Lineal/Class A rate (16)
14r .
~(
. 00
17. __
i
Amount of Line 14 at Sibling rate . 47 70 x 045 =
6,540.30
(17) 0 0 X 12 =
00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00
15 .
=
19.
Principal Tax Due .
X DO
TAX CREDITS: c19)= 6,540.30
rr~rnnrvi RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
07-27-2010 CD013106 255.79 4,860.00
03-28-2011 CD014200 .00 1,172.99
INTEREST IS CHARGED THROUGH 06-22-2011 TOTAL TAX PAYMENT 6,288 78
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 251.52
REVERSE SIDE OF THIS FORM INTEREST AND PEN.
7.84
TOTAL DUE 259.36
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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