HomeMy WebLinkAbout08-16-11®NOTICE O~F~ INHERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES APP,~~~~~~~r~l~~-NCE OR DISALLOWANCE
INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE
PO BOX 280601 0~ R~IIUL'~T~BN+S? ~14i1D ASSESSMENT OF TAX
HARRISBURG PA 17126-0601 ~~ ~~'~ `"" `~ ---'J REV-1547 IX AFP C12-10)
~L~~ !i~^
r;;~v ~J ~`.;°ii: ~.J DATE 08-01-2011
ESTATE OF HART MAVIS H
nr~~~.~q~~iK C~ DATE OF DEATH 11-19 - 2010
Q(ll-~~1Y~v ~~~'~; FILE NUMBER 21 10-1193
DAVID W DELUGE C~JA¢~'~~l~~F~!:I+'; ~~ ~~a COUNTY CUMBERLAND
301 MARKET ST ACN 101
PO BOX 109 APPEAL DATE: 09-30-2011
(See reverse side under Objections)
LEMOYNE PA 17043
Amount Reeitted C
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE y --RETAIN-LOWER POR_TION_ FOR YOUR RECORDS E~-~
- - - ----------- ------
REV-1547 EX AFP C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
---------------------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HART MAVIS HFILE N0.:21 10-1193 ACN: 101 DATE: 08-01-2011
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) ~i) .00 NOTE: To ensure proper
3. Closely Held Stock/Partnership Interest (Schedule C) C2) .00 credit to your account,
C3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) of this form with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 24,294.10 tax payment.
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) c6) .00
c7) 90,978.64
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: c8) 115,272 74
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)_ 14 mill g 9
10. Debts/Mortgage Liabilities/Liens (Schedule I)
clo) 290.47
11. Total Deductions
12• Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: If an assesssent was issued previously, lines 14, 15
reflect figures that include the total of ALL return
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 Tax Due
TAX CREDITS:
DATE ui~COUNT (+)
NUMBER INTEREST/PEN PAID C-)
02-14-2011 CD014020
05-18-2011 CD014485 526.32
.00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
tll) 14,802.36
c12) 100,470.38
c13) 00
c14) 100,470 38
and/or 16, 17, 18 and 19 will
s assessed to date.
cis) .00 x
cls) nn x
(17)_ ~n X
cla) 100,470.38 x
AMOUNT PAID
00 = .00
045 = .00
12 = .00
15 15,070.56
C19)° 15, 070.56
U,000.00
4,544.24
TOTAL TAX PAYMENT
15,070.56
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.