HomeMy WebLinkAbout08-31-11~ ~' ~ INHERITANCE TAX pennSy~VBnla ! ~
BuREau of INDIVIDUAL Ta~C.~s~ I !V `~If~ RECORD ADJUSTMENT
INHERITANCE TAX DIVISION - i~ .+, +' DEPARTMENT OF REVENUE
PD BOX 280601 I ~ - ~.~. REV-1593 IX AFP (12-10)
HARRISBURG PA 17128-0601
r-~~ r
C~FF-~~,~ .I' ~ ~,,~,~
RAY H SCOTT
521 LIBERTY ST
PO BOX 567
CLARION PA 16214
DATE
ESTATE OF
DATE OF DEA
FILE NUMBER
COUNTY
ACN
C
08-08-2011
GLASS THOMAS A
TH 04-11-2009
16 09-0185
CLARION
101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
421 MAIN STREET STE 24
CLARION PA 16214
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE y RETAIN__L__OW_E_R PORTION FOR YOUR
---------------------------------- _
RECORDS_
REV-1593 EX AFP C12-10) ** ""°"""""'"° ________
INHERITANCE TAX RECORD ADJUSTMENT **
ESTATE OF: GLASS THOMAS A FILE N0.:16 09-0185
ADJUSTMENT BASED oN:
PROTEST BOARD ACN: 101 DATE: 08-08-2011
DECISION
VALUE OF ESTATE:
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) C1) 19,002.00
3. Closely Held Stock/Partnership Interest (Schedule C) (2) $ 0,4 83.94
4. Mortgages/Notes Receivable (Schedule D) (3) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) .00
6. Jointly Owned Property (Schedule F) C5) 61 , 103 14
7. Transfers (Schedule G) (6) - 9 519 9
8. Total Assets (7)_ ?59 090 ?~
DEDUCTIONS AND EXEMPTIONS: (8)
429,198.60
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C9) 11,375.60
11. Total Deductions (10) 888.95
12. Net Value of Tax Return C11) 12,264 55
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (12)
14. Net Value of Estate Subject to Tax (13)
TAX: (14)
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 Tax Due
TAX CREDITS:
DATE NUMBER
01-06-2010 CL002228
01-06-2010 CL002229
05-28-2010 CL002349
06-14-2010 CL002361
L1Jl.UUNI (+)
INTEREST/PEN PAID C-)
.00
.00
48.56-
.00
6,401.64
17,364.97
4,326.93
366.59
TOTAL TAX PAYMENT 28,411.57
ALANCE OF TAX DUE 1,422.49CR
INTEREST AND PEN. .00
IF PAID AFTER DATE INDICATED, SEE REVERSE TOTAL DUE 1,422.4 R
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR], YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
416,934.05
.00
416,934.05
c15) .00X.00 =
c16) • 00
307,240.05X.045= 13,825.80
[17) 109,694.00x.12 = 13 163.28
(1s) .00,,.15 =
.00
(19) 26,989.08
AMOUNT PAID
REV-1G70 EX (01-10)
`~' pennsylvania
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 230601
HARRISB RG PA 17128-0601
DECEDENT'S NAME
Thomas A. Glass
REVIEWED BY
Joan M. Peters
ITEM
SCHEDULE NO.
-yHE~ITANCE TAX
EXPLANATION
OF CHANGES
FILE NUMBER
1609-0185
ACN
101
EXPLANATION OF CHANGES
The above referenced Account Control Number has been adjusted to reflect the changes
made to Schedules "F" and "G".
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