HomeMy WebLinkAbout05-20-11NOTICE OF INHERITANCE TAX pennsylvarna~ ~~ s
_.
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP C12-10)
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
KORI L HAYSLETT
313 HIGH ST
BARNESVILLE OH 43713
DATE 05-09-2011
ESTATE OF HAYSLETT TIMOTHY L
DATE OF DEATH 11-15-2003
FILE NUMBER 21 08-0719
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-08-2011
( 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 ~) RETAIN LOWER PORTION-FOR-YOUR-RECORDS- ~'•_ __________________
REV-1547 EX AFP C12-lO~
R
N CE
O
A
R OR
DEDUCTIONS
OF
DISALLOyIANCE OF
ASSESSMENT
AND TAX
ESTATE OF: HAYSLETT TIMOTHY LFILE N0.:21 08-0719 ACN: 101 DATE: 05-09-2011
TAX RETURN WAS: ( ) ACCEPTED AS FILED C X) CHANGED $EE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RET URN
(1) .00 NOTE: To ensure proper
1. Real Estate (Schedule A) 00 credit to your account,
2. Stocks and Bonds (Schedule B) C2) ,
00 submit the upper portion
Closely Held Stock/Partnership Interest (Schedule C)
3 (3) ' of this form with your
.
Mortgages/Notes Receivable (Schedule D)
4 (4) .00 tax payment.
.
Cash/Bank Deposits/Misc. Personal Property (Schedule
5 E) C5)
.00
. c6) .00
Jointly Owned Property (Schedule F)
6
. (7) .00
7. Transfers (Schedule G)
fig) .00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .00
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
.00
cll)
11. Total Deductions 00
C12) .
12. Net Value of Tax Return
C13) .00
13. Charitable/Governmental Bequests; Nonelected 9113 Trusts (Schedule J) 00
14. Net Value of Estate Sub]ect to Tax
c14)
.
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: 00 00 = .00
15. Amount of Line 14 at Spousal rate (15) .
00 X
x 04 5 =
0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) . .
C17) .00 X 12 .00
17. Amount of Line 14 at Sibling rate
8)
.00
X 15 =
.00
Amount of Line 14 taxable at Collateral/Class B ra
18 te (1
. c19)= . 00
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
+ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 E~ f6-88)
~~
Y INHERITANCE TAX
'~=-A_ ~~~:4V EXPLANATION
COMMONWEALTH OF PENNSYLVANIA OF CHANGES
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601 File Number
DECEDENT'S NAME Timothy Hayslett 2108-0719
ACN 101
REVIEWED BY Department of Revenue
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
Efforts to obtain an Inheritance Tax return have been exhausted for the above referenced
estate. Therefore, the filing requirements have been waived. The Department however,
reserves the right to assess any assets that may be recovered at a future time.
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