HomeMy WebLinkAbout07-15-11~~.~r,r;,,;i_,-_, LTICS OF INHERITANCE TAX Pennsylvania ~
BUREAU of INDIVIDUAL TAx~St' ` ~J1~'1~`1F`~~S~ENT, ALLOWANCE OR DISALLOWANCE
- DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~„ ,-. ~~i _ L- _ JpE`.',b~~UCTIONS AND ASSESSMENT OF TAX.
PO BOX 280601 ~ '~ - •~ REV-1547 EX AFP (12-10)
HARRISBURG PA 17128-0601
CLERK Or
~~iiO,1RPHAN'S COt JRT
JOHN H KLINGE~k~~CpA~~'~r,~~ ~n., PA
STE 2
1156 WALNUT BOTTOM RD
CARLISLE PA 17015
DATE 07'-04-2011
ESTATE OF GOLLICK KATHERINE
DATE OF DEATH 08-03-2010
FILE NUMBER 21 10-0808
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-02-2011
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ---- ---) RETAIN LOWER PORTION FOR YOUR
-------------------- ------------- RECO
R;DS F-
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REV-1547 EX AFP C12-10) NOTICE OF INHERITANCE TAX _
_
-
APPRAISEMENT, ALLOWANCE
__
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESS MENT OF TAX
ESTATE OF: GOLLICK KATHERINE FILE N0.:21 10-0808 ACN: 101 DATE: 07-04-2011
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAIS
D
E
VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 00
2. Stocks and Bonds (Schedule B)
(2) .
4,572.88 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)
00 of this form with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .
99,074.91 tax payment.
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7) 269,358.91
8. Total Assets
APPROVED DEDUCTIONS AN CB) _ 373,006.70
D EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cq) 19.E
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 54 0.71
11. Total Deductions
(111 19,736.06
12. Net Value of Tax Return C12) 353,270.64
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 353,270.64
NOTE: If an assessment was issued previously, li nes 14, 15 and/or 16
17 18
reflect figures that
include the total of
ALL ,
,
returns assessed to d and 19 will
ate
ASSESSMENT OF TAX: .
15. Amount of Line 14 at Spousal rate (15) .00 X 00 = 00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 3~i3,970.64 x 045 = .
15,897
18
17. Amount of Line 14 at Sibling rate C17) iQ
j~
X 12 = .
,
_ . 00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .IDO X 15 = 00
19. Principal Tax Due .
TAX CREDITS: C19)= 15,897.18
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
10-29-2010
05-02-2011 CD013571 786.14 14,936.74
CD014392 .00 174.32
TOTAL TAX P~4YMENT 15,897.20
BALANCE OF TAX DUE .02CR
INTEREST AN:D PEN. .00
TOTAL DUE .02CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D~
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.