HomeMy WebLinkAbout11-23-11NQTIC~,- OF INHERITANCE TAX pennSJ ~Van~a ~'` ~ ?;`
'p~PItArS~MENT," ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAxES pF . DEDU'CT14NS "AND ASSESSMENT OF TAX REV-1547 EX AFP <lz-lo)
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
- ~ DATE 11-14-2011
-~ ESTATE OF GREEN JAMES E
DATE OF DEATH 05-01-2011
FILE NUMBER 21 11-0555
COUNTY CUMBERLAND
,,~! ACN 101
ANDREW C SHEELY ES~! `' - pppEAL DATE: 01-13-2012
127 S MARKET ST (See reverse side under Objections)
PO BOX 95
MECHANICSBURG PA 17055 Amount Remitted
MAKE REGISTERA OFB WILLSD REMIT PAYMENT T0:
1 COURTHOUSE SQUARE
CARLISLE PA 17013
~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ______________
CUT ALONG_ THIS LINE --------------------------------------------------------
REV-1547 EX AFP C12-lO~DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENTAOFOTAXCE OR
JAMES EFILE N0.:21 11-0555 ACN: 101 DATE: 11-14-2011
ESTATE OF: GREEN
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
~1) .00 NOTE: To ensure proper
1. Real Estate (Schedule A) .00 credit to your account,
~2) submit the upper portion
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C) C4) .00 taxtpaymentm with your
4. Mortgages/Notes Receivable (Schedule D) 58,368.00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (6) 3,878.98
6. Jointly Owned Property (Schedule F) ~7) ,00
7. Transfers (Schedule G) (2,246.98
C8)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Estate Subject to Tax
c9) 10.944.57
clo) 1 , 346.09
Non-elected 9113 Trusts (Schedule J)
NOTE: If an assessment was issued previously,
reflect figures that include the total
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
c11) 12,290.66
c12) 49,956.32
t13) ' 00
c14) 49.956.32
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS: DISCOUNT (+)
PAYMENT RECEIPT
DATE NUMBER INTEREST/PEN PAID (-)
n7-21-2011 CD014746 112.40
n5) .00 x
C16) 4 9.956,_32_ X
cln - 00 x
cls) .00 x
AMOUNT PAID
00 = .00
045 = 2,248.03
12 = .00
15 = .00
c19)= 2,248.03
TOTAL TAX PAYMENT 2,248.03
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" (CR), YOU MAY BE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.