HomeMy WebLinkAbout07-15-11~ r'-` "~ ' ` - RITANCE TAX pennsylvania ~- i~
APPRAT~ Mf`NT:i 'AL,k~ ICE OR DISALLOWANCE DEPARTMENT OF REVENUE
,~ ? ., REV-1547 EX AFP (12-10)
u of INDIVIDUAL TAXES OF DEDUCTIONS A~ ASSESSMENT OF TAX
BUREA
INHERITANCE TAX DIVISION
PO BOX 280601 ';~~ ~ ` I } r( n ~ . I r ~.
HARRISBURG PA 17128-0601 i"~.r ~ ~~~ ~ `~ Cwt ~ ~-~~ `~% jDATE 07'-12-2011
BL.OSSER THELMA A
/~ ^ ESTATE OF
li~Ez1K O~ DATE OF DEATH 09-30-2010
~~p~,q~~ v~J{Jtll FILE NUMBER 2:L 10-1021
~f~~~ '~~~ ~5'~'! ~~~~ . PA. COUNTY CUMBERLAND
ACN 1D1
SUSAN H CONFAIR APPEAL DATE: 09-10-2011
2331 MARKET ST (See reverse side under Objections)
CAMPHILL PA 17011
Amount Remitted
MAKE REGISTER OFB WILLS REMIT PAYMENT T0:
1 COURTHOUSE SQUARE
CARLISLE F'A 17013
CUT ALONG_ THIS L_INE_____ ~) __RETAIN_LOWER PORTION FOR YOUR_RECORDS-__________
-----'" " "--- ALLOWANCE OR
REV-1547 EX AFP C12-lO~DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENA N F 101 DATE: 07-12-2011
THELMA AFILE N0.:21 10-1021
ESTATE OF : BLOSSER X ~ ) CHANGED
TAX RETURN WAS: ( ) ACCEPTED AS FILED
ORIGINAL RETURN
C1) 218,$50 NOTE: To ensure proper
APPRAISED VALUE OF RETURN BASED ON: 00 credit to your account,
1. Real Estate (Schedule A) ~2) ~ O submit the upper Portion
2. Stocks and Bonds (Schedule B) C3) ~,_ of this form with your
00 tax payment.
3. Closely Held Stock/Partnership Interest (Schedule C (4) --_
4. Mortgages/Notes Receivable (Schedule D) (5) 3,37,8 94.36
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (6) --
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (8) 556,756.86
g. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: ~~j, 3
F eral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cioj 149.7 2
9. un
Liabilities/Liens (Schedule I)
26,786.61
10. Debts/Mortgage X11) 529,970.25
Total Deductions
11 c12) .00
.
12. Net Value of Tax Return
Non-elected 9113 Tru C13)
sts (Schedule J 529 , 970.25
13. Charitable/Governmental Bequests; C14)
14. Net Value of Estate Subject to Tax
'
'
n
l
and 19 wil
If an assessment was issued previous la '
f d at
to
assessed
re~turnsa
ALL
o
OTE:
N
reflect figures that include the to
.00
ASSESSMENT OF TAX:
e 14 at Spousal rate
i ,00 x 00 =
c15)
)~ 970 F x 045 = 23,848.66
n
15, Amount of L
Line 14 taxable at Lineal/Class A rate (16
_
~~ X 12 ,00
16. Amount of (17) 00
17. Amount of Line 14 at Sibling rate
Collateral/Class B rate .00 x 15 =
(18)
(19)= .
23,848.66
lg, Amount of Line 14 taxable at
19. Principal Tax Due
TAX CREDITS: DISCOUNT (+) AMOUN PT IA D
PAYMENT RECEIPT
NUMBER INTEREST/PEN PAID ~-)
7,646.37
DATE 402.44
CD013823 699.60
12-27-2010
13,292.49
711.14
1
CD013824
12-27-2010 90.06 ,
6
59
12-27-2010 CD013825 .00 .
04-28-2011 CD014374
TOTAL. TAX PAYMENT 23,848.69
BALANCE OF TAX DUE .03CR
INTEREST AND PEN.
.00
.03CR
TOTAL DUE
REFLECTED AS A "CREDIT" (CR). YOU MAY BE DU°
IF TOTA
INDICATED. SEE REVERSE L DUE IS
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
A REFUND.
~ IF PAID AFTER DATE
ULATION OF ADDITIONAL INTEREST.
FOR CALC