HomeMy WebLinkAbout04-08-11BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
ROBERT G FREY
5 S HANOVER ST
CARLISLE
NOTICE OF INHERITANCE TAX
e~+A'F~;F~~gI'~'S~~ME~ ~-
~~'~ ~?~-OWANCE OR DISALLOWANCE
...
Of flE~D`UCT„i:p~ AND ASSESSMENT OF T
'L ,
.._- ~ _ ~ , ,t AX
'` s , ~
`,. 1.l
~ ~
r , ~ ,~
PA 17013
Pennsylvania ,
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-10) 1:
DATE 04-25-
ESTATE OF 2011
ADAMS C
DATE OF DEATH 09-09-2005 N
FILE NUMBER 21 05-0847
COUNTY CUMBERLAND
ACN 101
APPEAL DATE:
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T
REGISTER OF WILLS 0.
1 COURTHOUSE SQUARE
CUT ALONG THIS LINE CARLISLE PA 17013
REV-1547 Ej~ qFp-C12_10~ ___RETAIN-LOWER PORTION FOR YOUR
NOTICE OF INHERITANCE TAX --- RECORDS F..
ESTATE OF; DISALLOWANCE OF DEDUCTIONS ANDRAISEMENT ~ --------- ___
ADAMS ASSESSMENTAOFOTgXCE OR --"-"-
C NFILE NO.;
TAX RETURN WAS ; 21 05 - 084 7 ACN :
APPRAISED VALUE OF (X) ACCEPTED AS FILED 101 DATE: 04-25_2011
RETURN BASED ON: SUPPLEMENTAL ( ) CHANGED
1 • Real Estate (Schedule q) RETURN
N0. O1
2• Stocks and Bonds (Schedule B)
cl) .00
3• Closely Held Stock/Partnershi NOTE:
P Interest (Schedule C) C2) 2, 632. To ensure proper
4. Mortgages/Notes Receivable (Schedule D) 11 credit to your account,
(3) , 00 submit the
5• Cash/Bank Deposits/Misc. upper Portion
Personal Pro C4) .0 0 of this form with
6• Jointly Owned Pro Perty (Schedule E) Your
Perty (Schedule F) f5) tax payment.
7• Transfers (Schedule G) .0 0
c6) .00
$• Total Assets (7)
APPROVED DEDUCTIONS .00
9• Funeral Expenses/Ad D EXEMPTIONS:
cs) 2 632.11
10. Debts/Mort a e Costs/Misc. Expenses
g 9 Liabilities/Liens (Schedule ijchedule H)
C9) 1 1 ~, nn
11. Total Deductions (10)
12. Net Value of • 00
13. Tax Return
Charitable/Governmental Be C11) 115.00
14. Net Value of Quests; Non-elected 9113 Trusts (Schedule J) C12)
Estate Subject to Tax 2, 517 • 11
NOTE: If an C13) .00
assessment was issuedpreviousl (14)
reflect fi Y, lines 3 883.11
ASSESSMENT pF 9ures that include the total of 14' 15 and/or
TAX: ALL returns 16' 17' 18 and 19
15. Amount of Line 14 at s assessed to will
Pousal rate date.
16. Amount of Line 14 taxable at
17. Amount of Line 14 at Sibling rateal/Class A rate Cis) •0 0 =
c16) x 00 .00
3 RSA " x 045 =
18• Amount of Line 14 taxable at Collateral/Class B C17) 174.2 7
19. Principal Tax Due X 12 =
TAX CREDITS: rate C18) .00
.00 X 15 =
PAYMENT C19)= • 00
RECEIPT 1 74.27
DATE NUMBER DISCOUNT (+)
02-16-2006 INTEREST/PEN PAID (-) AMOUNT PAID
02-16-2006 CD006335
02-22-2011 CD006336 .00
CD014039 .00 59.00
32.18- 2.00
145.45
TOTAL TAX PAYMENT
BALANCE OF TAX DUE 174.27
INTEREST qND pEN• •00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE TOTAL DUE • 00
FOR CALCULATION OF ADDITIONAL INTEREST. „ •O 0
IF TOTAL DUE IS REFLECTED AS A
A REFUND. SEE REVERSE SIDE OF THISEFORM FOR) YOU MAY BE DUE
INSTRUCTIONS. `~
i