HomeMy WebLinkAbout04-08-11BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-Ob01
NOTICE OF INHERITANCE TAX
~i {~~~~~~d~$EM~~Tj~~ALLOWANCE OR DISALLOWANCE
~r.~ Uf ~E~~~~~+pjONS AND ASSESSMENT OF TAX
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STE (400
555 GETTYSBURG PIKE
MECHANICSBURG PA 17055
ennsylvania ~
P
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-10)
DATE 04-04-2011
MOORHEAD DUANE R
ESTATE OF
DATE OF DEATH 04-18-2010
FILE NUMBER 21 10-0425
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 06-03-2011
(See reverse side under Objections
Amount Remittedr
MAKE CHECK E AYOFB WI ANS REMIT PAYMENT T0:
REGIST
1 COURTHOUSE SQUARE
CARLISLE PA 17013
PORTION FOR YOUR RECORDS F••____________________
~ RETAIN LOWER_____ _ ______________ ____
CUT ALONG THIS___L_INE________ ___ _ ---- -
--'-'"-"----- 2-10 NOTICE OF INHERITANCE TAS ANDRASSESSMENTAOFOTAXCE 0 -
REV-1547 EX AFP C1 DISALLOWANCE OF DEDUCTION ACN: 101 DATE: 04-04 2011
niieNF RFILE N0.:21 10-0425
ESTATE OF: MOUKntN-u ---- ~ ) CHANGED
T..i nrT~~RN WAS• C X ) ACCEPTED AS FILED
^ ORIGINAL RETURN
APPRAISED VALUE OF RETURN BASED ON:
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. PersoielFjroperty (Schedule E)
6. Jointly Owned Property CSchedu
7. Transfers (Schedule G)
NOTE: To ensure proper
credit to your account,
submit the upper Portion
of this form with your
tax Payment.
Cs) 270,401.03
8. Total Assets
DEDUCTIONS AND EXEMPTIONS:
~R.740.81
APPROVED
ral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C1U) 1 0 58.2 5
9. Fune
Liabilities/Liens (Schedule I 39,299.06
10. Debts/Mortgage C11) 231 , 101.97
11. Total Deductions C12)
(13) , 00
12 . Net Value of Tax Return
Non-elected 9113 Trusts (Schedule
rnmental Bequests;
J~ C14) 231 , 101.97
13. Charitable/Gove
14. Net Value of Estate Subject to Tax 15
l and/or 16, 17, 18 and 19 will
If an assessment was issued preve
re~turn
f ALL
, s assessed to date .
o
NOTE:
t tal
reflect figures that include th ,00
.00 X 00 =
ASSESSMENT OF TAX: c15)
ousal rate
7'~1
t S
1 O1 . 97 x 045 = 10,399.59
p
C16)
15. Amount of Line 14 a
xable at Lineal/Class A rate
t
~
X 1 2 = , 00
C17)--
a
16. Amount of Line 14 _
- 00
17. Amount of Line 14 at Sibling rate
Collateral/Class B rate C18 .00 x 15 =
C19)= .
399.59
10,
18. Amount of Line 14 taxable at
19. Principal Tax Due
TAX CREDITS: DISCOUNT C+) AMOUNT PAID
PAYMENT RECEIPT
BER INTEREST/PEN PAID C-)
98
7
263
NUM
DATE 3$2.31
CD012986
00 .
,
2,753.30
.
06-24-2010 CD013897
01-13-2011
TOTAL TAX PAYMENT 10,399.59
BALANCE OF TAX DUE .00
.00
INTEREST AND PEN.
.00
TOTAL DUE
SEE REVERSE IF TOTAL DUE IS REFLECSIDEAOFATHISEFORM FOR)INSOTRUCTIONS,DUE
~ IF PAID AFTER DATE INDICATED, A REFUND. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
120,000.00
~1) 35,383.50
C2) .00
C3) .00
C4)
6 , 707 .43
c5) 76 , 665.58
C6) 31 , 644 .52
~~)