HomeMy WebLinkAbout04-08-11a
ERITANCE TAX pennsylvan~a ~; ~ ,,^
NOTICE •F INH 7;
-~' ~ ~' ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
~(~`,~~~ -;~ '- ~ ~ ~- RAISEMENT,
BUREAU OF INDIV~~`~L `~-~~~~ ',.',,'~i,"~ `' OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP clz-log
INHERITANCE TAX DIVI~ ,
PO BOX 280601 t '~ ~'ti ~ ~ -• t ~ ~ - 4~ J
HARRISBURG PA 17128-0601 4 - 04 - 2011
DATE 0
~' ' + 1 ~' ~'~' - ~ ~ .:~~ c... BAI R ANN
TATE OF
3 ; ~ ~,~ :+ j ES
DATE OF DEATH 09-30-2010
F I L E NUMBER 21 10 -1010
~~~~~( ~+~
T
ORQ~r'~~~ t/~~.,~Ri COUNTY CUMBERLAND
ARL~~~~e~~ ~'~" PA ACN 101
EAL DATE: 06-03-2011
CH
APP
3528 BRIBAN ST (See reverse side under Objections)
HARRISBURG PA 17111
Amount Remitted
A sD REMIT PAYMENT T0:
MAKE
B
A
WI
OF
REG STER
1 COURTHOUSE SQUARE
CARLISLE PA 17013
LOWER PORTION FOR YOUR RECORDS F" ___
____
-~ RETAIN ----'"-"'"-- ____________
LONG_ THIS LINE _____________________________
CE OR
A
U T
C
INHERITANCE
O
A
R
_
_
__
TAX
OF
- 547 EX AFP (12-10 NOTICE OF
ASSESSMENT
ONS AND
REV 1 DISALLOWANCE OF DEDUCTI
E
04-04-2011
:
ACN: 101 DAT
EFILE N0.:21 10-1010
ESTATE OF: BAIR ANN
C ) CHANGED
TAX RETURN WAS: C X ) ACCEPTED AS FILED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
~1) .0 0 NOTE:
To ensure proper
1. Real Estate (Schedule A) .0 0 credit
C2) submit to your account,
the upper portion
2. Stocks and Bonds (Schedule B)
~3) '~ ~ of thi
C)
s form with your
Closely Held Stock/Partnership Interest (Schedule
.0 0 tax payment.
3
.
C4)
Mortgages/Notes Receivable (Schedule D) 232, 608.12
4
.
sh/Bank Deposits/Misc. Personal Property (Schedule E) C6~ .0 0
C
a
5.
.0 0
Jointly Owned Property (Schedule F)
6
C7)
.
7. Transfers (Schedule G) C8) 232,608.12
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: ~ 165.70
'
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
168.4 6
9
lU)
.
(
Debts/Mortgage Liabilities/Liens (Schedule I)
10 3,3 34.1 6
.
(11)
229,273.96
c12)
11. Total Deductions
.0 0
12. Net Value of Tax Return C13)
ritable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C14)
Ch
3 2 2 9 2 7 3,9 6
a
.
1
14. Net Value of Estate Subject to Tax 17, 18
15 and/or 16,
14 and 19 will
,
lines
NOTE: If an assessment was issued previously,
f ALL returns assessed to date
.
reflect figures that include the total o
ASSESSMENT OF TAX: .00 X 00 =
(15)
14 at Spousal rate
6 X 045 = .00
10 , 317 .33
15. Amount of Line
c16) 229 27~_. q
ount of Line 14 taxable at Lineal/Class A rate
0 0 X 12 =
A .0 0
.
m
16.
c17)
17. Amount of Line 14 at Sibling rate .0 ~ X 15 = , 00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) (19)= 10,317.3 3
19. Principal Tax Due
TAX CREDITS: DISCOUNT C+) AMOUNT PAID
RECEIPT
PAYMENT
ATE NUMBER INTEREST/PEN PAID C-)
33
317
10
.
,
D
.00
01-27-2011 CD013954
TOTAL TAX PAYMENT 10,317.33
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CC
FORM FO R), YOU MAY BE DUE
R INSTRUCTIONS.
* IF PAID AFTER DATE INDICATED,
A REFUND. SEE REVERSE SIDE OF THIS
FOR CALCULATION OF ADDITIONAL INTEREST.