HomeMy WebLinkAbout04-08-11~.
ERITANCE TAX pennsy~Van~a ~_,;T
NOTICE OF INH
n-.~-r r>-r~;~~~[[''}a1PPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE ;
OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP c12-lo)
BUREAU OF IND U~'~ °"f;AX~,S ` '~C. l~'
INHERITANCE TAX DY~Y, QN ~~~ ~, ~ !% 1 `.
PO BOX 280601 [ i ,. ,.~ ' ~ ~ - ~.•`1
HARRISBURG PA 17128 ~d~
4-04-2011
DATE 0
~ ~~'~~ -~ ~ ,~ ~~ ~ ESTATE OF SIEMON MARCELLA P
,J • ~;.
t
~t+; i a i
DATE OF DEATH 04-25-2010
C~ER~ ~~ FILE NUMBER 21 10-0750
LAND
>>r~ r~~j~€~? COUNTY CUMBER
~''~ ~
a~P~
101
:
ACN
ROB~~~~' l~„~e.~•, PA" APPEAL DATE: 06-03-2011
S T E C -10 0 (See reverse side under Objections )
555 GETTYSBURG PIKE Amount Remitted
MECHANICSBURG PA 17055
A gD REMIT PAYMENT T0:
MAKE
B
WI
REG STER OF
1 COURTHOUSE SQUARE
CARLISLE PA 17013
YOUR RECORDS ~
______
~ RETAIN LOWER PORTION FOR --------
OR -------
----
CUT ALONG THIS _LINE__________________________
CE
INHERITANCE TAX APPR
O
A
--~
TAX
OF
FP C12-10~ NOTICE OF
ASSESSMENT
"'"_---
REV 1547 EX A DISALLOWANCE OF DEDUCTIONS AND
E
04-04-2011
:
ACN: 101 DAT
MARCELLA PFILE N0.:21 10-0750
ESTATE OF: SIEMON
CCEPTED AS FILED C ) CHANGED
TAX RETURN WAS: CX) A
APPRAISED VALUE OF RETURN BASED 0N: ORIGINAL RETURN
(1) 541 , 350.00 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
3. Closely Held Stock/Partnership Interest (Schedule
C4) .0 0 tax pa yment.
Mortgages/Notes Receivable (Schedule D) 19,968.27
4
.
Cash/Bank Deposits/Misc. Personal Property (Schedule E) (6~ ,0 0
5
.
6. Jointly Owned Property (Schedule F) C7) 265,445.87
7. Transfers (Schedule G) C8) 82(, 764.14
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: 48.907.83
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C1U) 440,041.30
Debts/Mortgage Liabilities/Liens (Schedule I)
10 488,943.13
(11)
. 337 , 821.01
c 12)
11. Total Deductions ,0 0
12. Net Value of Tax Return C13)
4)
nmental Bequests; Non-elected 9113 Trusts (Schedule J)
3 3 7,8 21.01
C1
13. Charitable/Gover
14. Net Value of Estate Sub]ect to Tax I$
15 and/or 16, 17,
14 and 19 Will
,
lines
NOTE: If an assessment was issuedpreviouslY,
f ALL returns assessed to date
.
reflect figures that include the total o
ASSESSMENT OF TAX: ,00 X 00 =
C15)
14 at Spousal rate
01 X 045 =
1 .00
15,201.95
Ci6) ~~7 $2
.
15. Amount of Line
ount of Line 14 taxable at Lineal/Class A rate
0 0 X 1 2 =
A ,0 0
.
m
16.
(17)
17. Amount of Line 14 at Sibling rate .~ 0 X 15 = . 00
f Line 14 taxable at Collateral/Class B rate C18) (19)= 15,2 0 1.9 5
18. Amount o
19. Principal Tax Due
TAX CREDITS: DISCOUNT C+) AMOUNT PAID
RECEIPT
PAYMENT
TE NUMBER INTEREST/PEN PAID C-)
00
000
8
.
,
DA
421.05
07-23-2010 CD013094 .00 6,780.90
01-25-2011 CD013942
TOTAL TAX PAYMENT 15,201.95
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
DSEEIREVERSECSIDEAOFATHISEFORM FOR)INSOTRUCTIONS.DUE
PAID AFTER DATE INDICATED, SEE REVERSE IF TO
UND.
~ F
I A REF
FOR CALCULATION OF ADDITIONAL INTEREST.