HomeMy WebLinkAbout11-23-11BUREAU OF INDIVIDUAL TAXES - R NOTICE OF
INHERITANCE TAX p1VISION INHERIT
PO BOX 280601 1'1 ~R~rSZ~i~~ ALLOWANCE OR CE TAX
HARRISBURG PA I71zs-o6o1 DF DEIIUC~TIONS DISALLO
_ r AND ASSESSMENT OF TAX E
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HAMILTON `~~ ;i ~~ ;';~~'
C DAVISf ~.~,~- _ ,.,, ' ~.
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20 E BURD ST
SHIPPENSBURG
PA 17257
Pennsylvania ~; ~'
DEPARTMENT OF ,-
REVENUE
REV-1547 EX AFP C12-10) "'.'""°~
DATE
ESTATE OF 11-07-2011
DATE OF KLIGGE
DEATH 10- JOSEPH C
FILE NUMBER 20-2010
COUNTY 21 11-0778
ACN CUMBERLAND
101
APPEAL DATE:
(See reverse side under 1 - 0 6 - 2 012
Amount Re ~blections)
witted
MAKE CHECK PAYABLE AND
REGISTER OF WILLS REMIT
1 COURTHOUSE S PAYMENT T0:
CUT ALONG THIS LINE CARLISLE QUARE
REV-1547 EX AFP ----- ~ RETAIN PA 17013
I12-lp~ NOTICE OF -LOWER P~RTION FO
ESTATE DISgLLOWANCENOFRITANCE R YOUR RECORDS
OF: KLIGGE DEDUCTIONX APPRAISEMENT E~ __ _
JOSEPH NS AND ASSESSMENTAOFOTANCE OR -"
(FILE N0.:21 11- AX -----
APPRAISED VALUE OF rqx RETURN WqS: 0778 ACN:
RETU ~ X) ACCEPTED 101 DATE:
1' Real Estate [SchedulRA)BASED ON: ORIGINAL AS FILED 11_07_
RETURN ~ ) CNANGED 2011
2• Stocks and Bonds Schedule 8)
3• Closely Held Stoc (I)
4• Mort k/Partnership Interes •00
gages/Notes Receivable t CSc C2) NOTE.
(Schedule D) hedule C) ,00 TO ensure proper
5• Cash/Bank (3) credit
Deposits/Misc. .QQ submit to your account
6• Jointly Owned pro Personal C4) the upper '
Pert Property CSche ,QQ °f this portion
~• Transfers y (Schedule F) Jule E) C5) form with your
[Schedule G) 3, 397.85 tax payment.
B• Total Assets cs) 61,836.07
APPRpyED DEDUCTIONS AND ~~)
EXEMPT 26,489.67
9• Funeral Expenses/ IONS:
10. Debts/Mort Adm' Costs/Misc. Expenses [8)
gage Liabilities/Liens Schedule N) 91 723.5 g
11. Total Deductions (Schedule I) C9)
12. Net Value of T C10)
13, ax Return 2 150.37
Charitable/Governmental Bequests;
14. Net Value of Estate C11)
Non-elected 9113 10, 138 • 37
NOTE: Subject to Tax Trusts (Schedule J) C12)
If an asses 81,585.22
reflect fi sment was issued c13)
ASSESSMENT OF 9ures that preylously, 1 c14) •00
TAX: include the Ines 81 585.22
15. Amount of total 14' 15 and/or 16, 17,
Line 14 at S of AFL returns assessed to
16. Amount pousal rate 18 and 19 Wfll
°f Line 14 taxable at Li date,
17• Amount of Line 14 at Heal/Class C15)
Siblin A rate • 00 X 00
18. Amount of g rate C16) _
19. Principal Tax Due C17)
Line 14 taxable at Collateral/Class X 045 = '00
TAX CREDITS: B rate X 12 _ 3'671.33
C18) -
PAYMENT ' 00 X 15 _ • 00
DATE RECEIPT • 00
Q 7_ NUMBER DISCOUNT ~+) C19)=
12-2011 CD014703 INTEREST/p 3, 671 .33
EN PgID ~_) AMOUNT PgID
•00
3,671.3
TOTAL TAX PAYMENT
BALANCE OF TAX DUE 3'671.33
INTEREST AND pEN• •00
IF PAID AFTER DATE INDICATED, SEE
FOR CALCULATION OF ADDITIONAL rorAL DUE • 00
REVERSE
INTEREST. IF TOTAL DUE IS REFLECTED qS „ •00
A REFUND. SEE REVERSE SIDE
OFA CREDIT~~ (CR), YOU Mqy BE DUE
THIS FORM FOR INSTRUCTIONS.