HomeMy WebLinkAbout08-31-11 (2)BUREAU OF INDIVIDUAL f•~~4~s APPfCAT NOTICE OF INHERITANCE
INHERITANCE TAX DIVISION ~.,~ I CEMENT, ALLOWANCE TAX
Po Box zsocol •~F SEDUCTIONS AND OR DISALLOWANCE
HARRISBURG PA lnze-ocol ::~•' .. ASSESSMENT OF TAX
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pennsy(vania'
DEPARTMENT OF REVENUE
REV-1547 IX AFP (12-10)
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_~ DATE OS-22-2011
ESTATE OF BRANDY
1 C^ i ~`-
•~_,--F, ,~,~ DATE OF DEATH 11 - PAUL S
`1~~=~FarlP~ fi ,, -_T FILE 22-2010
GRACE E gR ~` ~ v :_. ~ ~ ;, NUMBER 21 11 - 0236
G'~`~~ ~ " COUNTY
591 LOCUST LN ~ CUMBERLAND
MECHANICSBURG ACN 101
PA 17055 APPEAL DATE:
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CUT-ALONG THIS LINE CARLISLE PA 17013
REV-1547 EX AFP C12-101 ~ --RETAIN_LOWER POR_TION__FOR YOUR
NOTICE OF INHERITANCE TAX ""'--- RE(:ORDS (.
BRANDY -------__ __
ESTATE OF: DISALLOWANCE OF DEDUCTIONS AND RASSESSMENTAOFOTAXCE OR
PAUL SFILE NO.;
TAX RETURN wAS: 21 11-0236 /1CN: 101 DATE:
APPRAISED VALUE OF RETURN B (X) ACCEPTED AS FILED 08-22-2011
1• Real Estate (Schedule A) AS ED 0 ORIGINAL ( ) CHANGED
N0 RETURN
2• Stocks and Bonds (Schedule B) _
3• Closely Held Stock/Partnershi (1) ~ ~ NOTE:
P Interest (Schedule C) TO ensure proper
4• Mortgages/Notes (2)~~~~ 0 credit to your account,
5. Cash/Bank Receivable (Schedule D) C3)-~- submit
Deposits/Misc. the upper portion
Personal Pro of this form with your
6• Jointly Owned Perty (Schedule 4)-~~~~ tax
Property (Schedule Payment.
7• Transfers (Schedule G) F) E) (5)-~~~
(6)12, 546.00
$• Total Assets
APPROVED DEDUCTIONS (~)~,U4
9. Funeral Expenses/AdD EXEMPTIONS;
(a) 209 588.53
10. Debts/Mort a e Costs/Misc. Expenses (Schedule H)
g 9 Liabilities/Liens (Schedule I) C9)-~~
11. Total Deductions C10) --~ 76 00
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; C11)
14. Net Value of Non-elected 9113 Trusts (Schedule J) 5,2 76.12
Estate subject to rax (12) 204, 312.41
NOTE: If (13) • 00
an assessment was issued previously,
reflect fi (14) 204 312.41
ASSESSMENT OF 8ures that include lines 14, 15 and/or
TAX: the total of ALL 16' 17' 18 and
15. Amount of Line 14 at s returns assessed 19 will
16. Amount of Line 14 taxablesat Lineal/Class A rate t0 date.
C15) . L~0
17• Amount of Line 14 at Siblin X 00
9 rate C16)_ 9p4 1 7 r1 x • 00
1B• Amount of Line (17) 045 = 9, 194.06
14 taxable at Collateral/Class ~ X
19. Principal Tax Due 12 -
TAX C B rate (lg) .00
REDITS: .00 X 15 =
PAYMENT C19)- • 00
RECEIPT 9, 194.06
DATE DISCOUNT (+)
02-22- NUMBER INTEREST/pEN PAID (-)
2011 CD014037 AMOUNT PAID
458.43 8,710.1
INTEREST IS
AT THE CHARGED THROUGH 09-06-
O
RATES
REVERSE SIDE APPLICABLE AS OUTLINED
ON
TOTAL TAX PAYMENT
THE
OF THIS FORM BALANCE OF TAB; DUE 9,168.61
INTEREST AND iPEN. 25.45
* IF PAID AFTER
FOR CALCULATI DATE INDICATED,
RSE
ON OF ADDITION TOTAL DUE
IF • 03
25.4$
AL INTEREST TOTAL DUE IS REFLECTED qg A ~~CREDIT"
A REFUND. SEE REVERSE S CCR)
IDE OF THIS FORM ,
DUE
FOR INSTRUCT
IONS,
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