HomeMy WebLinkAbout07-05-11BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
ANDREW PSZCZOLKOWSKI
1883 ASTER RD
G ~~ ~~~~t~ f~ RITANCE TAX pennsylvania ~. ~
APPR~~ '~ r.~(, NCE OR DISALLOWANCE
t !~~T"`: DEPARTMENT OF REVENUE
OF ~~~D~'G~~~IOiVS" At~t~ ASSESSMENT OF TAX REV-1547 IX AFP C12-lo)
1,. 4i r ~ ~w' ~ 1w~ ~ ~ ~, 1 ' o i 1+y ~~
DATE 06-20-2011
~~R~ O~ T ESTATE OF PSZCZOLKOWSKI THOMAS C
DATE OF DEATH 11-10-2010
~~P~`~~S ~~UFt FILE NUMBER 21 10-1152
~`~~~'~~~~'~ ~`~~ ~'~ ~ ~~' COUNTY CUMBERLAND
ACN 101
MACUNGIE PA 18062
APPEAL DATE: 08-19-2011
(See reverse ,side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ---- --~ R_ETA_IN LOWER POR
TION
FOR YOUR RECORDS ~
REV-15 _
_
47 EX AFP C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT,-ALLOWANCE _
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: PSZCZOLKOWSKI THOMAS (FILE N0.:21 10-1152 ACN: 101 DATE: 06-20-2011
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 0 0
2.
Stocks and Bonds (Schedule B) C2) .
,Q Q NOTE• To ensure proper
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .0 0 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D) C4)
0 0 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 15,0 6 7.9 8
6. Jointly Owned Property (Schedule F) C6) .0 0
7. Transfers (Schedule G) C7) .0 0
8. Total Assets
APPROV
ED DEDUCTIONS AND EXEMPTIONS: c8) 15,067.98
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 7,4 8 8.9
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 5,2 91.0 9
11. Total Deductions C11) 12, 780.01
12. Net Value of Tax Return C12) 2, 287.97
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 2,287.97
NOTE: If an assessment was issued previously, lines 14, 15 and/'or 16, 17 , 18 and 19 will
reflect figures that include the total of ALL returns assessed to date
ASSESSMENT OF TAX: .
15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) ? . ?87.97 X 045 = 1 02.95
17. Amount of Line 14 at Sibling rate C17) 0 0 X 12 =
18.
Amount of Line 14 taxable at Collateral/Class B rate C18)
.0 0 X 15 .0 0
= .0 0
19. Principal Tax Due
TAX CRE
DITS: C19) = 102.95
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED A5 A "CREDIT" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.