HomeMy WebLinkAbout11-23-11BUREAU OF INDIVIDUgL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
JAMES D BOGAR
I W MAIN ST
SHIREMANSTOWN
~"~~~ ':-N0~'.IQ~ INHERITANCE TAX
AiI~PRAISEM~ENT'~„ r
,`~'OF DEDUCTI'Dry~,LOWANCE OR DISALLOWANC
__,,~j AND ASSESSMENT E
of rax
,, ~,
Pennsylvania
DEPARTMENT OF REVENUE
REy-1547 p( AFP (12-10) `"'~--
DATE
ESTATE OF 11-07-2011
DATE FOUGHT
OF DEATH 01-p3_ JAY W
FILE NUMBER 2011
COUNTY 21 11-0109
ACN CUMBERLAND
APPEAL 101
DATE: _
(See reverse side under 1 ~ 6 - 2012
Aa o u n Ob'ections)
t Remitted
MAKE CHECK P
REGISTER OFBLE AND REMIT p
WILLS AYMENT T0:
1 C
~~'~ ~~
,,~~~~
G~Fr ~ ~ ~, ,T
~~ .f... 1' ~ / 11
PA 17011
OURTHOUSE SQUARE
CUT ALONG THIS LINE CARLISLE
REV-1547 EX AFP ---__ ~- R_ETA__IN PA 17013
(12-10~ NOTICE OF 'LOWER-PORTION FOR
ESTATE DISALLOyyANCENHERITANCE TAX "'--YOUR RECORDS t~
OF: FOUGHT OF DEDUCTIONS ANDRAISEMENT, --'--- _
JAY ASSESSMENTALLOWANCE OR --'-
WFILE NO „ 21 11_ OF TAX ------_
APPRAISED Tnx RETURN wAS: 0109 ACN:
VALUE OF RETU c X) ACCEPTED AS FILED 101 DATE:
1• Real Estate cscheduleRq)BASED ON: ORIGINAL c ) CHANGED 11-07-2011
2- stocks RETURN
end Bonds
3• Closel (Schedule g)
Y Held Stock/Partnershi cl) 809, 000.00
4• Mortga9e5/Notes p Interest C2) NOTE: To
Receivable (Schedule C) .00 ensure proper
5• Cash/Bank De Schedule D) [3) credit to your account,
6 Jolntl Posits/Misc. Personal pro •00 submit the
y Owned pro C4) of upper portion
Perty (Schedule Perty (Schedule ,00 this form with
7• Transfers F) E) (5) tax payment, y°ur
(schedule G) 228,273.46
B• Total Assets C6) .00
APPROVED DEDUCTIONS c7) 186,631.51
9• Funeral AND EXEMPTIONS:
10. Debts/MoExPenses/Adm• Costs/Misc. (B)
tgege Liabilities/ Expenses CSche 1 223 904.97
Liens dule H)
11. Total De (Schedule I) (9)
ductions C10)
12. Net Value of Tax 47 000.00
13. Charitab Return
le/Governmental Bequests; Non-
14. Net Value of Estate C11)
Subject to Tax elected 9113 Trusts 126' 420' 11
NOTE: (Schedule J) C12) 1' 097, 484.86
If an assess c13)
reflect fi gent was issued previously, •00
ASSESSMENT 9ures that lines C14j 1 097 484.86
OF TAX: include the total 14' 15 and/or
15. Amount of Line 14 at of A~ returns 16' 17' 18 end
16. Amount of Spousal rate aSSesSed tp 19 Will
Line 14 taxable date,
17• Amount °f at Lineal/Class C15)
Line 14 at Siblin A rate .00 X 00
18. Amount of 9 rate (16)~~D 9 ~
Line 14 taxable at ~ n~ x 045 = ' 00
19. Principal Tax Due Collateral/Class (17) 4 9
TAX CREDITS; B rate x 12 386.82
C18)
DATE
03-3~ 1
10-31-2011
NUMBER
REFUND
INTEREST/PEN' ~+)
PAID ~_)
2,469.34
•00
FORpCALCULATIONAOF INDICATED,
SEE REVERSE
ADDITIONAL INTEREST.
•00 x 15 = •00
c19)= . 00
49,386.82
AMOUNT PAID
,u16.45
98.97-
TOTAL TAX PAYMENT
BALANCE OF TAX DUE 49'386'82
INTEREST AND pEN• •00
TOTAL DUE •00
IF TOTAL DUE IS REFLECTED •00
A REFUND. SEE REVERSE SIDEADFA '~CREDIT'~
THIS F CCR)' YOU MAY BE
ORM FOR INSTRUCTIONS.