HomeMy WebLinkAbout09-14-11BUREAU OF IA4AL TA
INHERITANCd9 I'$'ION ~~ ~~
PO BOX 2806~~~ . ,~',5 ~ C
HARRISBURG PA~~I,I28-.Q60'1._. ''-i•'~
~_ ..,:..
NOTICE OF INHERITANCE TAX Pennsylvania ~
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-10)
~,, ,4
~4 5~? 14 ~ f: • ~:.J
dC~„ERK ~Y
WM QRF~~R`~~~~Q
1~~' ~R ~b'R'G STREET
DILLSBURG PA 17019
DATE 09-05-2011
ESTATE OF GOCHENOUR BEVERLY D
DATE OF DEATH 09-19-2010
FILE NUMBER 21 10-0999
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-04-2011
(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 C12-10~ NOTICE OF INHERITANCE TAX APPR AISEM ENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSES SMENT OF TAX
ESTATE OF: GOCHENOUR BEVERLY DFILE N0.:21 10-0999 ACN: 101 DATE: 09-05-2011
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
Real Estate (Schedule A)
1 (1) .00 NOTE: To ensure proper
. (2) 417.4 0 credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 7,8 69.73
6. Jointly Owned Property (Schedule F) (6) 14,009.59
7 T ansfers (Schedule G) (7) .0 0
r
8. Total Assets cs) 22,296.72
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 19.78 6.88
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
C11) 19,786.88
11. Total Deductions 2,509.84
12. Net Value of Tax Return (12) 00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .
T (14) 2,509.84
14. ax
Net Value of Estate Subject to
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) .
X
16. Amount of Line 14 taxable at Lineal/Class A rate C16] 7. x,09 _ 84 X 045 = 112.94
17. Amount of Line 14 at Sibling rate (17) _00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 1 5 = .00
C19)= 112.94
14. Principal Tax Due
TAX CREDITS: __
PAYMENT RECEIPT DISCOUNT (+) I AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-13-2011 CD014572 .00 112.94
TOTAL TAX PAYMENT 112.94
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" CCR), YOU MAY BE D
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.