HomeMy WebLinkAbout10-28-11 (3)~~ ~ }J:O`~I~ OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~+E(,~tF~A~~~.~~, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ',- OF 'pED~'C''T#ONS AND ASSESSMENT OF TAX
PO BOX 280601 ~_~~'~ • ~-
HARRISBURG PA 17128-0601
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BRYAN S BREIZ~IGAM ~~~"'~~"~ ,`,`.,~~i '~;~ ~ ~A
SUITE 200
1 W CHOCOLAT~ AVE
HERSHEY ' PA 17033
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-10)
DATE 10-18-2011
ESTATE OF SIMMONS SR LAWRENCE W
DATE OF DEATH 07-01-2010
FILE NUMBER 21 10-0709
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 12-17-2011
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
--T-ALONG-THIS-LINE __
REV-1547 EX AFP C12~ -- ~ --RETAIN-LOWER-PORTION-FOR-YOUR-RECORDS- ~ -------------------
10~ NOTICE OF INHERITANCE TAX APPRAISEMENT,, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SIMMONS ~R LAWRENCE WFILE NO 21 10 07.09 ACN: 101 DATEe 10-18-
TAX RETURN WAS: CX) ACCEPTED AS FILED
APPRAISED VALUE OF ETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSch dule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Sto k/Partnership Interest (Schedule C)
4. Mortgages/Notes eceivable [Schedule D)
5. Cash/Bank Deposi s/Misc. Personal Property [Schedule E)
6. Jointly Owned Pr party (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS
9. Funeral Expenses/
10. Debts/Mortgage Li
ND EXEMPTIONS:
dm. Costs/Misc. Expenses [Schedule H)
bilities/Liens (Schedule I)
C ) CHANGED
2011
C1) •00 NOTE: To ensure proper
C2) 834,440.12 credit to your account,
C3) .00 submit the upper portion
of this form with your
C4) 50,000.00 tax payment.
C5) 3, 817.64
C6) .00
cn 1,031,952.98
CB) 1 , 920 , 410 74
C9)- ~7 468 64
Clo)_ 4,335 35
11. Total Deductions
12. Net Value of Tax eturn C11) 61,803.99
13. Charitable/Govern ental Bequests; Non-elected 9113 Tru
t (13) 1'85 8,606.75
14. Net Value of Esta a Subject to Tax s
s (Schedule J) .00
NOTE:
If cl4) 1,858,606 75
an assess ant was issued previously, lines 14, 15 and/or 16
17
reflect ffgu
es that include the total
of ALL ,
,
and 19 will
ASSESSMENT OF TAX: returns assessed to d to
15. Amount of Line 14 ' at Spousal rate C15) 494 , 816
69
00
16.
Amount of Line 14
taxable at Lineal/Class A rate
C16) .
=
X
)
;A;
79
• 00
17. Amount of Line 14 at Sibling rate •
•
0 Nb X
045 = 61,370.55
18.
Amount of Line 141
~
taxable at Collateral/Class B ra C17)
te C18) nn x 12 =
OD .00
19.
Principal Tax Due
! .
X 15
_
.00
TAX CREDITS: ~I C19)= 61,370.55
..~..~ar i DISCOUNT (+)
DATE NUM ER INTEREST/PEN PAID (-)
-31-2011 CDO1 236 .00
~ IF PAID AFTER DATE INDIC TED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
AMOUNT PAID
J ! V
TOTAL TAX PAYMENT 61,370.55
BALA TAX DUE •00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUBS
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~-