HomeMy WebLinkAbout08-31-11NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES `-
'~} ~ ~ ~ APPR~t1~E~NT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX Drv1s1oN - OF L1f~ErUCTIONS AND ASSESSMENT OF TI~X
PO BOX 280601
HARRISBURG PA 17128-0601
CLERK; %?~_
ORFf-'j,~~J'> (CURT
JON A YOST CIJA.;i.~,''-(:~ `J'' i~,`1 ~A
320 W CHOCOLATE AVE
PO BOX 437
HERSHEY PA 17033
[7) .00
CUT ALONG THIS LINE y --RETAIN LOWER POR_TION
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FOR YOUR RECOiRDS
REV-1547 EX AFP C ~
_
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12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE O
------------------
OR
F DEDUCTIONS AND ASSESSMENT' OF
ESTATE OF: REHM TAX
HAZEL MFILE N0.:21 11-0146 A(:N:
101
DATE: 08-15-2011
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) I1) .00 NOTE: To ensure
proper
3. Closely Held Stock/Partnership Interest (Sched
(2)
l •0 0 credit to your account,
b
u
e C)
C3)
4. Mortgages/Notes Receivable (Schedule D) .00 su
mit the upper portion
of this form with
(4) ' 00
5. Cash/Bank Deposits/Misc. Personal Propert
(S your
tax payment.
y
chedule E) (5) 6 3,8 7$
6. Jointly Owned Property (Schedule F) ,70
7. Transfers (Schedule G) (6) .00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortg:age Liabilities/Liens (Schedule I)
11. Total Deductions
12• Net Value o1' Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Estate Subject to Tax
cs) 63,878 70
c9) 4=007.07
clo) 6, 192.12
Non-elected 9113 Trusts (Schedule J)
Pennsylvania
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-10) ~1~11~
DATE 08-15-2011
ESTATE OF ftEHM HAZEL M
DATE OF DEATH 01-17-2011
FILE NUMBER 21 11-0146
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-14-2011
(See reverse side under Objections)
Amount Remitted~-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16 17
reflect figures that include the total of ALL returns assesse
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Ta;K Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-)
04-08-2011 CD014283
05-31-2011 CD014517 115.79
.00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
cls) , pp X
C16) S ~ 679 ~ X
c17) ~ x
c19) .00 X
AMOUNT PAID
cll) 10, 199.19
cl2) 53,679.51
n3) .00
ci4) 53,679 51
, 18 and 19 will
d to date.
00 = .00
045 = 2,415.58
12 = .00
15 = .00
c19)= 2,415.58
2,200.00
99.79
TOTAL TAX PAYMENT
2,415.58
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS i4 "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.