HomeMy WebLinkAbout04-08-11TAX ennsylvania `~`` ~~
NOTICE OF INHERITANCE
~T, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE r
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BUREAU OF INDIVIDUAL TAXES~~~ ~ i"' CTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP clz-log
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INHERITANCE TAX DIVISION , ~ f
PO BOX 280601 ~~~ '" v -
HARRISBUR6 PA 17128-0601 04-04-2011
„~ _ ~ , ,w DATE HOWARD J
' ~ ~~ ~ ~' ~'~~ ~ ~' ESTATE OF MESICK SR
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DATE OF DEATH 12-22-2009
C~~~K ~~' FILE NUMBER 21 10-0059
~PN~~'~ ~fl~~R~ COUNTY CUMBERLAND
PHYLLIS A MES~BE~?~-~<C) ~,Q„ P~, ACN 101
APPEAL DATE: 06-03-2011
10 F A I R F I E L D S T (See reverse side under Objections )
NEWVILLE PA 17241-1306
Amount Remitted
MAKE C LISTER OF W1 A SD REMIT PAYMENT T0:
RE
1 COURTHOUSE SQUARE
CARLISLE PA 17013
LOWER PORTION FOR YOUR RECORDS F"~ ___________________
CUT ALONG__T__H_IS_ LINE- _ ~ __RETAIN_ __ __ ___ ""'
'"' ---- p C12-10) NOTICE OF INHERITANCE TAX ANDRASSESSMENTAOFOTAXCE OR
REV-1547 EX AF DISALLOWANCE OF DEDUCTIONS A
ACN: 101 DATE: 04-04-2011
HOWARD JFILE N0.:21 10-0059
ESTATE OF: MESICK SR
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
C1) .0 0 NOTE: To ensure proper
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
.0 0 credit to your account,
1. Real Estate (Schedule A) C2) submit the upper portion
2. Stocks and Bonds (Schedule B) C3) •0 0 of this form with your
3. Closely Held Stock/Partnership Interest (Schedule C) C4) .0 0 tax payment.
4. Mortgages/Notes Receivable (Schedule D) 64 8.6 2
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C6) .0 0
6. Jointly Owned Property (Schedule F) C7) .0 0
7. Transfers (Schedule G) C8) 648.62
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: ~.'~72.~Z
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C1U) $ 3.9 3
10. Debts/Mortgage Liabilities/Liens (Schedule I) tll) 3,4 5 6.5 0
C12) 2,807.88-
11. Total Deductions .0 0
12. Net Value of Tax Return C13)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C14) 2,8 0 7.8 8-
14. Net Value of Estate Subject to Tax 1$ and 19 Will
lines 14, 15 and/or 16, 17,
NOTE: If an assessment was issued previously,
reflect figures that include the total of ALL returns assessed to date.
.00 X 00 = .00
ASSESSMENT OF TAX: C15) .00
15. Amount of Line 14 at Spousal rate C16) .0 0 X 0 4 5
16. Amount of Line 14 taxable at Lineal/Class A rate X 12 = .0 0
C17) . 00
17. Amount of Line 14 at Sibling rate .0 0 X 15 =
C19)= . 00
18. Amount of Line 14 taxable at Collateral/Class B rate C18
19. Principal Tax Due
TAX CREDITS : DISCOUNT C+) AMOUNT PAID
PAYMENT RECEIPT
DATE NUMBER INTEREST/PEN PAID C-)
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
DATE INDICATED, SEE REVERSE IF TOTAL DUEEIREVERSECSIDEAOFATHISEFORM FOR)INSORUCTIONS.DUE
* IF PAID AFTER A REFUND. SE
FOR CALCULATION OF ADDITIONAL INTEREST.