HomeMy WebLinkAbout09-14-11 (2)BUREAU OF INDIVIDUAL TA~,Q !fit r~;- q NOTICE OF INHERIT
INHERITANCE TAX DIVISION ~ ~~ti ~~" ~Af OR~~S ENT, ALLp{ygNCE pR CE TAX
PO BOX 280601 F`
HARRISBURG Pq 17126.0601 F_~_ - ~,e,f UCTIONS AND DISALLOWANCE
_ , ` I 1 ASSESSMENT OF TAX
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C~~~K ~~
ROBERT H MCC ~~PH~~S ' IdU~T
23 SOUTH 29TH 5~~.~``(~) n~~ PA
CAMP HILL
PA 17011
Pennsylvania
DEPARTMENT OF REVENUE •
REV-1547 EX AFP (12-10) ~"""
DATE
ESTATE OF 09-05-2011
DATE OF MCCULLOWGH
DEATH 03-Og_ JIMMIE L
FILE NUMBER 2U11
21 11-007
COUNTY CUMBERLAIND
ACN
APPEAL 101
DATE: 11-04-2011
(See reverse side under IDb~ections)
Amount Remitted
MAKE CHECK PAYABLE ANDEMIT p
REGISTER OF WILLS AYMENT TO:
I COURTHOUSE SQUARE
CUT ALON_6_ THIS LINE CARLISLE pq
REV-1547 - ---_ y RETAIN 17013
EX AFP C12-10~- -__ -LOWER-PORTION FOR YOUR
NOTICE OF INHERITANCE -- RECORDS ~.
ESTATE OF; DISALLOWANCE OF TAX APPRAISEMENT ______
MCCULLOUGH DEDUCTIONS AND ASSESSMENTAOF TAXC~ OR
JIMMIE LFILE --'
N0.:21 11-0607
APPRAISED TAX RETURN WAS: (X) ACCEPTED ACN: 101
VALUE OF RETURN As FILED DATE: 09-05-2011
1 • Real Estate (Schedule A) BASED ON: ORIGINAL ( ) CHANGED
2• stocks RETURN
and Bonds (Schedule B)
3• Closely Held Stock/partnershi C1) 128' 000 • 00
4. Mort P Interest (2) 211 NOTE: To ensure proper
gages/Notes Receivable (Schedule C) '549.00 credit
5• Cash/Bank (Schedule D) (3) .00 submit the your account,
Deposits/Misc. Personal pro upper
6• Jointl (4) of this form p°rtion
y Owned Propert party (Schedule E) •00 with your
7. Transfers y (Schedule F) C5) 22 0,81 9.16 tax payment.
(Schedule ~)
B• Total (6) • 00
APPROVED D Assets C7)
EDUCTIONS AND •00
9• Funeral Ex EXEMPTIONS:
penses/Adm. Costs/Misc. (B) 560
10. Debts/Mort Expenses 368 • 16
gage Liabilities/Liens (Schedule I)chedule H)
11. Total Deductions (9)
clo) 35.00
12. Net Value of Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Non- C11) 8, 726.97
Estate Sub elected 9113 Trusts (Schedule J) (12)
NOTE: ject to Tax 551 , 641.1 g
If an assessment was (13)
reflect issued previousl (14) •00
ASSESSMENT OF figures that include y' lines l4, 551 641.19
TAX: the total of q~ re 15 and/or 16, 17, ~8
15, amount of Line 14 at turns assessed and 19 will
16. Amount of Spousal rate t0 da'te.
Line 14 taxable at Lineal/Class
17. Amount of C15)
Line 14 at Siblin A rate (16) rr, • 00 X 00
18• Amount of 9 rate =~~ 6!+] I9 .00
Line 14 taxable at (17) i"'-~ X 04 5 =
19. principal Tax Due Collateral/Class B rate 24 ~ 823 • 85
TAX CREDITS: (18) X 12 =
DATE ••~•-cir ~
NUMBER DISCOUNT (+)
-23-2011 CD014500 INTEREST/PEN PAID (-)
1,237.76
.00 X 15 = .00
c19)= • 00
24,823.85
AMOUNT PAID
,71/,
PAYMENT MUST BE MADE BY
12"08-2011*.
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT
BALANCE OF TAX DUE 24'755.13
INTEREST AND pEN• 68'72
TOTAL DUE •00
IF TOTAL DUE 68 • 72
A REFUND. IS REFLECTED AS A ~~CREDIT~~
SEE REVERSE SIDE OF THIS FORM FOR) YOU MAY BE DUE
INSTRUCTIONS.
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